Glecaprevir and Pibrentasvir Combination Antiviral Therapy for Hemodialysis Patients Infected with the Hepatitis C Virus

Abstract

Background and Aims:The population of patients on hemodialysis (HD) is considered one of the most accessible for the implementation of the WHO HCV Infection Eradication Program. Until recently the main obstacle to its elimination was the lack of antiviral drugs for the treatment of HCV genotypes 2 and 3 in patients with a low glomerular filtration rate. The new combination of Glekaprevir/Pibrentasvir opens up additional opportunities to achieve this goal. The aim of the study was to assess the efficacy and safety of this therapy in patients with stage 5 chronic kidney disease receiving HD.Methods: 16 HD patients with HCV genotypes 2 (one with the recombinant 2k/1b subtype) and 3 were treated with GLE/PIB for 8 or 12 weeks depending on the degree of fibrosis.Results: A sustained virological response at 12 and 24 weeks was achieved in all patients with a minimum number of adverse events. In 13 of 14 patients, positive changes to transient liver elastography parameters were detected after completion of the antiviral therapy. However, this could be associated with a decrease in the inflammatory activity of the disease rather than with the decreased severity of hepatic fibrosis. Conclusion:HCV infection treatment with GLE/PIB in hemodialysis patients is effective and safe.