Response to direct-acting antiviral agents in chronic hepatitis C patients with end-stage renal disease: a clinical experience

Abstract

SUMMARY OBJECTIVE The recent development of direct-acting antiviral agents (DAAs) has dramatically changed the treatment of chronic hepatitis C, and interferon-based regimes have become a poor treatment choice in clinical practice. Today DAAs offer shorter, well-tolerated, highly effective curative therapies. This study aimed to evaluate the effectiveness and safety of DAAs in patients with end-stage renal disease and HCV genotype 1 infection in real clinical practice. METHODS Thirty-six patients who attended our clinic, were diagnosed with chronic hepatitis C (CHC), undergoing hemodialysis, and fulfilled the criteria of age >18 years, genotype 1 infection, with a detectable HCV RNA level were considered for the study. Patients with GT1a infection received OBV/PTV/r plus DSV plus RBV for 12 weeks; GT1b infected patients received this regimen without RBV for 12 weeks. RESULTS The study was conducted on 33 patients. The mean age was 52.30 ±13.77 years, and 70 % of them were male. By the fourth week of treatment, HCV RNA levels decreased below 15 IU/ml in all patients. Sustained virologic response (SVR) 12 rate was 100%. Nine patients had side effects during treatment. Of the patients with side effects, 89.9% were in group 1a and 11.1% in group 1b. CONCLUSION In this study, treatment with OBV/PTV/r and DSV with or without RBV resulted in high rates of sustained virologic response in HCV GT1-infected patients with end-stage renal disease (ESRD). SVR was achieved in all patients with few side effects.

Genotypes of Hepatitis C Virus and Efficacy of Direct-Acting Antiviral Drugs among Chronic Hepatitis C Patients in a Tertiary Care Hospital

“…Regarding patients with chronic kidney disease, the results of this study were in concordance with previous studies in the literature [ 46 , 47 ]; they found that treatment with OBV/PTV/R and DSV with or without RBV was safe and effective in HCV-infected patients with chronic renal disease.…”

“…There was no statistically significant difference in SVR12 rates between patients treated with SOF-based regimens and those treated with other regimens regardless of whether they also used RBV. This was in line with previous research and real-world studies from all over the world, showing similar outcomes with high SVRs across a wide range of regimens, genotypes, and durations of therapy with or without the addition of RBV and in both treatment-naïve and treatment-experienced patients [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Additionally, the previous use of an antiviral medication by the patient did not affect the SVR rate.…”

A Systematic Review of Direct-Acting Antivirals for Hepatitis C in Advanced CKD

“…Across 3817 patients, only 35 were on peritoneal dialysis. 9 , 22 , 23 , 24 , 26 , 29 , 30 , 31 , 34 , 37 , 38 , 39 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 The s...…”