Hepatitis C virus infection has a high rate of chronicity and antiviral therapy is an important tool to stop the progression of chronic hepatitis C to end-stage liver disease. Antiviral treatment for hepatitis C has gone through the era of interferon monotherapy, combination of plain interferon and ribavirin, and combination of pegylated interferon and ribavirin. Although pegylated interferon in combination with ribavirin remains the current standard of care for HCV in China, a significant number of patients are still not cured or cannot tolerate this regimen. 2011 has seen the rapid development of small molecule compounds targeting viral proteins specific to the HCV life cycle, and a new era of direct antiviral agents (DAAs) is now underway. DAAs have shown attractive prospects in clinical studies:DAAs not only significantly improve antiviral efficacy and have high cure rates, but also have low side effects, low drug resistance rates and short treatment courses, and future antiviral therapy for hepatitis C will be based on combination therapy. Direct antiviral drugs against HCV mainly include non-structural protein NS 3/4A protease inhibitors, NS5A inhibitors and NS5B nucleoside and non-nucleoside polymerase inhibitors. The NS3/4A protease inhibitors currently approved for marketing are the first-generation protease inhibitors Telaprevir (Telaprevir) and Boceprevir (Boceprevir), and the second-generation protease inhibitors Simeprevir, Asunaprevir, Paritaprevir, and Grazoprevir. First-generation protease inhibitors, Telaprevir and Boceprevir, were initially used in combination with pegylated interferon and ribavirin for anti-HCV viral genotype 1 therapy. However, side effects were more common and severe with combination therapy with Telaprevir or Boceprevir; resistance and interactions with certain drugs limited the use of first-generation protease inhibitors. Second-generation protease inhibitors were also initially used in combination with pegylated interferon and ribavirin for anti-HCV genotype 1 treatment, but it was later discovered that second-generation protease inhibitors could also be used for genotypes 2, 4, 5, and 6. Compared to first-generation protease inhibitors, second-generation protease inhibitors are more convenient to use and have less potential for drug toxicity and interactions with other drugs. NS5A inhibitors have a strong antiviral effect with minimal side effects and no significant interactions with known drugs. The main NS5A inhibitors that have been marketed so far are Daclatasvir and Ledipasvir. NS5B inhibitors are currently available in two main types: Sofosbuvir (Sofosbuvir), a nucleoside (acid) inhibitor; and Dasabuvir, a non-nucleoside inhibitor.NS5B inhibitors have pan-genotypic activity and minimal toxicity and drug interactions.Sofosbuvir was the first to be approved by the FDA by Gilead (USA), and was launched on It is the first effective and safe drug for the treatment of certain types of HCV infection without the need for concomitant interferon. The availability of interferon-free, direct-acting antiviral drug combination regimens offers a boon and new hope for patients with hepatitis C, which is now considered a curable disease. A variety of different combination regimens of direct-acting antivirals have entered the clinic. Harvoni (Gilead), a combination of Ledipasvir and Sofosbuvir, was approved by the FDA on October 10, 2014 for the treatment of patients with GT1 HCV and is the first all-oral anti-hepatitis C regimen approved for the treatment of patients with genotype 1 HCV and does not require a combination of interferon or ribavirin, and in November 2015 Harvoni was approved by the FDA for an expanded indication for patients with genotype 4, 5, and 6 HCV and HIV co-infection. Daclatasvir and Sofosbuvir combination regimen (EU combination), approved for marketing by the European Medicines Agency (EMEA) in 2014, has shown good efficacy in particularly difficult-to-treat hepatitis C. In July 2015, the FDA approved Daclatasvir in combination with Sofosbuvir for the treatment of HCV genotype 3 infection. in August 2015 In August 2015, Health Canada announced the approval of Daclatasvir in combination with Sofosbuvir for HCV infection in patients with decompensated cirrhosis, post-liver transplantation, and HCV/HIV-1 co-infection. The combination regimen of ombitasvir/paritaprevir/ritonavir and dasabuvir (Viekira Pak), which was approved by AbbVie in December 2014 by the FDA for adult patients with HCV, consists of ombitasvir/ of ombitasvir, paritaprevir and ritonavir Viekira Pak is recommended only for the treatment of patients with genotype 1 HCV infection. the drugs in the Viekira Pak combination are metabolized in the liver by drug-metabolizing enzymes and excreted from the body, and is not recommended for patients with decompensated cirrhotic patients are treated with ViekiraPak. In July 2015 the FDA approved AbbVie’s Technivie (ombitasvir/ paritaprevir /ritonavir) in combination with ribavirin for the treatment of adult HCV patients with genotype 4 without cirrhosis. technivie in combination with RBV for 12 weeks resulted in an SVR 12 of 100%. Technivie is also not recommended for patients with moderate hepatic impairment. Zepatier (Merck Sharp & Dohme), a combination formulation of the second-generation protease inhibitor Grazoprevir and the NS5A inhibitor Elbasvir, was approved by the FDA on January 28, 2016 for the treatment of patients with chronic hepatitis C genotypes 1 and 4. Treatment with Zepatier with or without RVB for 12-16 weeks resulted in SVR 12 of 94%-97% in genotype 1 patients and 97%-100% in genotype 4 patients. However, Zepatier is not indicated for patients with Child-Pugh B and C liver function. Gilead’s latest hepatitis C drug, Sofosbuvir + Velpatasvir (Sofosbuvir + Velpatasvir), is expected to be approved by the FDA in June 2016. This combination regimen cures all patients with hepatitis C genotypes 1 through 6. A revolution is occurring in the treatment of hepatitis C. The treatment of a number of difficult-to-treat special populations, including patients who have failed PEG-IFN/RBV therapy, are non-responders, are co-infected with HIV or HBV, have genotype 3 HCV, are intolerant to interferon or have contraindications to interferon, have cirrhosis, and have transplants, has been addressed or is close to being addressed.