‘Real-life’ experience with direct-acting antiviral agents for hepatitis C virus in end-stage renal disease

García-Agudo, Rebeca; Aoufi-Rabih, Sami; Salgueira-Lazo, Mercedes; González-Corvillo, C.; Fabrizi, Fabrizio

doi:10.1177/0391398818763478

Cited by 8 publications

(4 citation statements)

References 33 publications

(38 reference statements)

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“…23,24 The SVR 12 rate from a recently published study ranged from (58-100% ) in patients with advanced CKD with Sofosbuvir based regimen. 25 In a multicenter experience of Sofosbuvir based regimens in end stage renal disease, the researchers measured plasma levels of Sofosbuvir and its active metabolite and confirmed the accumulation of active metabolite in plasma but it didn't led to any clinically significant adverse effects. The success rate in this trail was 88%.…”

Section: Discussionmentioning

confidence: 99%

“…24 Anemia was noticed to be associated with the use of Ribavarin despite being used at lower doses. 25 Mostly the studies have used reduced dose (half or alternate day) of Sofosbuvir in these patients. In a multicenter observational prospective study, authors compared daily full dose of Sofosbuvir with thrice weekly dose and it was noticed that Sofosbuvir itself or its inactive metabolite didn't accumulate in plasma with either regimen in between the dialysis session and drug was well tolerated by the study population.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of sofosbuvir based antiviral therapy for chronic hepatitis C infection in patients with advanced chronic kidney disease

et al. 2019

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Background: Screening studies for hepatitis C have proved that it is more prevalent in patients with renal diseases. Chronic hepatitis C infection in patients with kidney disease not only accelerates renal deterioration but also adversely effects morbidity and mortality. Availability of direct acting antiviral drugs has revolutionized treatment of hepatitis C even in difficult patients. In advanced kidney diseases, selection of treatment is difficult. Aim of this study was to evaluate the efficacy and safety of Sofosbuvir based DAAs in patients with advanced CKD.Methods: In this Quasi experimental study, CHC patients with or without cirrhosis having advance CKD (eGFR <30 ml/min per 1.73 m2) and/or on dialysis were enrolled. End points of the study were documentation of SVR 12 or discontinuation of therapy. Different regimens of oral DAAs with or without Ribavirin were used.Results: 86 patients with a median age of 53 years were enrolled. 37 patients were on maintenance dialysis and 49 were not on dialysis with eGFR <30 ml/min per 1.73 m2. Virological response was 92.68% at the end of treatment and SVR was achieved by 90.2% twelve weeks after therapy. Insomnia 14%, headache 11% and anemia 7% were main dverse effects. Mean eGFR and creatinine before and after treatment remained the same. Only 2 patients relapsed, both were on dialysis thrice weekly.Conclusions: All Sofosbuvir based regimens used for the treatment of CHC in patients with end stage renal disease are effective and well tolerated. Close follow up is advised to monitor side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sofosbuvir based antiviral therapy for chronic hepatitis C infection in patients with advanced chronic kidney disease

et al. 2019

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“…One major limitation of the information reported above is that it is mostly based on industry-funded studies, and these kinds of studies are more likely to be published if results are favourable [30]. However, numerous real-life studies on the same point have been completed supporting the conclusions reported above [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45].…”

Section: Pi-containing Sof-free Daas (Real World Studies)mentioning

confidence: 99%

An Updated View on the Antiviral Therapy of Hepatitis C in Chronic Kidney Disease

Fabrizi

Cerutti

2021

Pathogens

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Background: Hepatitis C virus infection remains common in patients with chronic kidney disease, including those on maintenance dialysis. The relationship between hepatitis C virus infection and chronic kidney disease is bi-directional; in fact, HCV is both a cause and consequence of chronic kidney disease. According to a systematic review with meta-analysis of observational studies (n = 23 studies) (n = 574,081 patients on long-term dialysis), anti-HCV positive serologic status was an independent and significant risk factor for death in patients with advanced chronic kidney disease on long-term dialysis. The overall estimate for adjusted mortality (all-cause death risk) with HCV was 1.26 (95% CI, 1.18; 1.34) (p < 0.0001). Interferon-based therapies are biased by low efficacy/safety in chronic kidney disease, but the advent of direct-acting antiviral drugs has made a paradigm shift in the treatment of HCV-infection. These medications give interruption of viral replication because they target specific non-structural viral proteins; four classes of DAAs exist-NS3/4A protease inhibitors, NS5A inhibitors, NS5B nucleoside and non-nucleoside polymerase inhibitors. All-oral, interferon-free, ribavirin-free combinations of DAAs are now available. Aim: The goal of this narrative review is to report the available treatment options for HCV in advanced chronic kidney disease. Methods: We have made an extensive review of the medical literature and various research engines have been adopted. Results: Some combinations of DAAs are currently recommended for HCV in advanced CKD (including patients on maintenance dialysis): elbasvir/grazoprevir; glecaprevir/pibrentasvir; and sofosbuvir-based regimens. Solid evidence, based on registration and “real life” studies supports their efficacy (SVR rates > 90%) and safety even in patients with advanced CKD. No dosage adjustment is necessary and treatment duration is 8–12 weeks. However, recent data highlight that many patients with advanced CKD remain untreated, and numerous barriers to antiviral treatment of HCV still exist. Whether successful antiviral therapy with DAAs will translate into improved survival in the advanced CKD population is another point of future research.

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“…On the other hand, dialysis patients are at increased risk of acquiring the virus due to poor hygiene, increased risk of nosocomial infection and lack of proper sterilization techniques along with improper handling of equipment. Hence, testing all dialysis patients at entry and periodically thereafter is recommended[ 66 , 67 ]. However, there is some controversy on the type of testing (serology or NAT) in these patients[ 68 ].…”

Section: Kidney Involvement In Chronic Hcv Infectionmentioning

confidence: 99%

Revolution in the diagnosis and management of hepatitis C virus infection in current era

Hanif¹,

Majid²,

Luck³

et al. 2022

WJH

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Chronic hepatitis C virus (HCV) infection is a major global public health problem, particularly in developing part of the world. Significant advances have been made in the early diagnosis and treatment of the disease. Its management has been particularly revolutionized during the past two decades. In this review, we summarize the major advances in the diagnostic and management armamentarium for chronic HCV infection. The focus of the present review is on the newer directly acting anti-viral agents, which have revolutionized the management of chronic HCV infection. Management of uncomplicated chronic HCV infection and of specific complications and special at-risk populations of patients will be covered in detail. Despite the advent and approval of highly effective and well tolerable oral agents, still many challenges remain, particularly the affordability, the equitable distribution and access to later drugs. The World Health Organization aims to eliminate viral hepatitis including HCV by 2030 since its poses a major public health threat. There is an urgent need to ensure uniform and early access to diagnostic and therapeutic facilities throughout the world if the later goal has to be realized.

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‘Real-life’ experience with direct-acting antiviral agents for hepatitis C virus in end-stage renal disease

Cited by 8 publications

References 33 publications

Efficacy and safety of sofosbuvir based antiviral therapy for chronic hepatitis C infection in patients with advanced chronic kidney disease

Efficacy and safety of sofosbuvir based antiviral therapy for chronic hepatitis C infection in patients with advanced chronic kidney disease

An Updated View on the Antiviral Therapy of Hepatitis C in Chronic Kidney Disease

Revolution in the diagnosis and management of hepatitis C virus infection in current era

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