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Non-structural protein 5B inhibitors are a class of direct-acting antivirals widely used in the treatment of chronic hepatitis C. Depending on site of action and chemical composition, NS5B inhibitors may be categorized into three classes—nucleoside active site inhibitors , non-nucleoside allosteric inhibitors, and pyrophosphate analogues. Subsequently, all three classes are then subclassified. All inhibit RNA synthesis by NS5B but at different stages/sites resulting in inability of viral RNA replication. Expression of direct-acting NS5B inhibitors does not takes place cells that are not infected by hepatitis C virus, which seems to be beneficial for this class of drugs.
Low efficacy, serious side effects, development of resistance of previously available hepatitis C treatments were the greatest concerns prior to the development of direct-acting antivirals, and remained a problem at the beginning of their development. Therefore, combinational direct-acting antiviral therapies were preferable. Research has demonstrated that specific anti-hepatitis C virus agents such as NS5B inhibitors lead to improved efficacy and tolerability.