Abstract:Rapid progression of chronic kidney disease (CKD) is seen in patients with hepatitis C virus (HCV) infection compared with uninfected patients. Despite the high efficacy of direct-acting antivirals (DAAVs), their cost represents a limiting factor to their use in developing countries.
Aim. This study aimed to evaluate the efficacy of low dose Sofosbuvir along with Daclatasvir in the management of HCV infection in end-stage renal disease (ESRD) patients.
Methods. A total of 82 HCV positive patients o… Show more
“…A total of seven studies satisfied our pre-defined selection criteria and were included in the meta-analysis. 4,[17][18][19][20][21][22] The flow diagram for the search strategy is shown in Figure 1.…”
Section: Resultsmentioning
confidence: 99%
“…The seven studies that were finally incorporated in the meta-analysis included four single-centre studies (3 from India and 1 from Bangladesh) and three multicentric studies. 4,[17][18][19][20][21][22] One of the multicentric studies was conducted across 22 centres in Europe, North America and Australia, another was conducted in 18 haemodialysis centres of 3 Taiwanese cities, and the third study was conducted in 15 academic centres of Taiwan. 4,21,22 Five of the studies were prospective while the studies by Gaur et al and Liu et al were retrospective.…”
Section: Resultsmentioning
confidence: 99%
“…4,21,22 Five of the studies were prospective while the studies by Gaur et al and Liu et al were retrospective. 4,[17][18][19][20][21][22] All the studies were published between 2019 and 2021. Modified NOS score was ≥5 for all the included studies.…”
Section: Resultsmentioning
confidence: 99%
“…In all the studies, the fixed-dose combination of 400 mg of SOF and 100 mg of VEL was given daily for 12 weeks. 4,[17][18][19][20][21][22] Majority of the patients were on maintenance haemodialysis (98.05%) and only 8 (1.95%) patients were on peritoneal dialysis. 4,[17][18][19][20][21][22] Data about gender were extractable in 246 patients, of whom 151 (61.4%) were males.…”
Section: Resultsmentioning
confidence: 99%
“…4,[17][18][19][20][21][22] Majority of the patients were on maintenance haemodialysis (98.05%) and only 8 (1.95%) patients were on peritoneal dialysis. 4,[17][18][19][20][21][22] Data about gender were extractable in 246 patients, of whom 151 (61.4%) were males. 4,17,18,21 Details of prior treatment history was present in 293 patients, among whom 21 (7.2%) patients had previous treatment exposure while 272 (92.8%) patients were treatment naïve.…”
Introduction: Sofosbuvir (SOF) and velpatasvir (VEL) is a pan-genotypic regimen for the treatment of Hepatitis C virus (HCV) infection. The data on the efficacy and safety of this regimen is end-stage renal disease (ESRD) is scanty. This systematic review and metaanalysis was done to ascertain the efficacy and safety of SOF and VEL in patients with chronic Hepatitis C (CHC) and ESRD on renal replacement therapy (RRT).Methods: Systematic search of Pubmed, Embase, Scopus, and Google Scholar was conducted using the search term (end-stage renal disease OR renal replacement therapy OR chronic kidney failure OR severe renal impairment OR chronic kidney disease OR haemodialysis OR dialysis OR peritoneal dialysis) AND (sofosbuvir OR velpatasvir OR NS5A inhibitors OR directly acting antivirals). Pooled sustained virologic response (SVR) and adverse event rates with 95% confidence intervals were estimated.Results: Seven studies (410 patients with CHC and ESRD on RRT) fulfilled our eligibility criteria. The overall pooled SVR rate of SOF and VEL in patients with HCV on RRT was 97.69% (95% CI: 95.71 to 98.92). There was no significant heterogeneity (I 2 : 39.3%, p-value of Cochran's Q = 0.13) among the studies. The pooled estimate of efficacy of SOF-VEL combination among patients with cirrhosis was 91.94% (95% CI 77.03-98.52). Pooled SVR rates in genotype 3 infection [94.6%, (95%: CI 81.3-99.4)] was comparable to that in those with documented non-genotype 3 infection [94.63%, (95% CI 87.12-98.44)]. No serious adverse event attributable to SOF and VEL was reported in the included studies.
Conclusion:The fixed-dose combination of SOF and VEL is effective and safe in CHC patients with ESRD on RRT.
“…A total of seven studies satisfied our pre-defined selection criteria and were included in the meta-analysis. 4,[17][18][19][20][21][22] The flow diagram for the search strategy is shown in Figure 1.…”
Section: Resultsmentioning
confidence: 99%
“…The seven studies that were finally incorporated in the meta-analysis included four single-centre studies (3 from India and 1 from Bangladesh) and three multicentric studies. 4,[17][18][19][20][21][22] One of the multicentric studies was conducted across 22 centres in Europe, North America and Australia, another was conducted in 18 haemodialysis centres of 3 Taiwanese cities, and the third study was conducted in 15 academic centres of Taiwan. 4,21,22 Five of the studies were prospective while the studies by Gaur et al and Liu et al were retrospective.…”
Section: Resultsmentioning
confidence: 99%
“…4,21,22 Five of the studies were prospective while the studies by Gaur et al and Liu et al were retrospective. 4,[17][18][19][20][21][22] All the studies were published between 2019 and 2021. Modified NOS score was ≥5 for all the included studies.…”
Section: Resultsmentioning
confidence: 99%
“…In all the studies, the fixed-dose combination of 400 mg of SOF and 100 mg of VEL was given daily for 12 weeks. 4,[17][18][19][20][21][22] Majority of the patients were on maintenance haemodialysis (98.05%) and only 8 (1.95%) patients were on peritoneal dialysis. 4,[17][18][19][20][21][22] Data about gender were extractable in 246 patients, of whom 151 (61.4%) were males.…”
Section: Resultsmentioning
confidence: 99%
“…4,[17][18][19][20][21][22] Majority of the patients were on maintenance haemodialysis (98.05%) and only 8 (1.95%) patients were on peritoneal dialysis. 4,[17][18][19][20][21][22] Data about gender were extractable in 246 patients, of whom 151 (61.4%) were males. 4,17,18,21 Details of prior treatment history was present in 293 patients, among whom 21 (7.2%) patients had previous treatment exposure while 272 (92.8%) patients were treatment naïve.…”
Introduction: Sofosbuvir (SOF) and velpatasvir (VEL) is a pan-genotypic regimen for the treatment of Hepatitis C virus (HCV) infection. The data on the efficacy and safety of this regimen is end-stage renal disease (ESRD) is scanty. This systematic review and metaanalysis was done to ascertain the efficacy and safety of SOF and VEL in patients with chronic Hepatitis C (CHC) and ESRD on renal replacement therapy (RRT).Methods: Systematic search of Pubmed, Embase, Scopus, and Google Scholar was conducted using the search term (end-stage renal disease OR renal replacement therapy OR chronic kidney failure OR severe renal impairment OR chronic kidney disease OR haemodialysis OR dialysis OR peritoneal dialysis) AND (sofosbuvir OR velpatasvir OR NS5A inhibitors OR directly acting antivirals). Pooled sustained virologic response (SVR) and adverse event rates with 95% confidence intervals were estimated.Results: Seven studies (410 patients with CHC and ESRD on RRT) fulfilled our eligibility criteria. The overall pooled SVR rate of SOF and VEL in patients with HCV on RRT was 97.69% (95% CI: 95.71 to 98.92). There was no significant heterogeneity (I 2 : 39.3%, p-value of Cochran's Q = 0.13) among the studies. The pooled estimate of efficacy of SOF-VEL combination among patients with cirrhosis was 91.94% (95% CI 77.03-98.52). Pooled SVR rates in genotype 3 infection [94.6%, (95%: CI 81.3-99.4)] was comparable to that in those with documented non-genotype 3 infection [94.63%, (95% CI 87.12-98.44)]. No serious adverse event attributable to SOF and VEL was reported in the included studies.
Conclusion:The fixed-dose combination of SOF and VEL is effective and safe in CHC patients with ESRD on RRT.
Background and objectives:Treatment of viral hepatitis C in chronic kidney disease patients with glomerular filtration rate < 30 ml/min/1.73 m 2 remains a challenge in countries with combinations containing only sofosbuvir. We investigated the efficacy and safety of sofosbuvir based regimens in patients infected with hepatitis C virus and stage 4 and 5 chronic kidney disease.
Methods:We conducted a multicentric, retrospective study of patients records treated for viral hepatitis C and chronic kidney disease. We collected data on adverse events, renal function during and after treatment, and virological response during and after treatment.
Results:We recruited 28 patients, including 13 patients on maintenance haemodialysis and 17 men. The mean age was 60.68 ± 13.00 years. Cirrhosis was found in 12 (43%) patients. The genotypes found were 1, 2 and 4. There were 27 (96.4%) treatment-naïve patients. The different combinations found were: Sofosbuvir 400 mg twice a week + ribavirin 200 mg daily (3.6%, n = 1), sofosbuvir 400 mg + daclatasvir 60 mg daily (21.6%, n = 6), sofosbuvir 400 mg + ledipasvir 90 mg daily in two patients, twice a week in 9 patients and three times a week in one patient (43.2%, n = 12), sofosbuvir 400 mg + velpatasvir 100 mg daily in 6 patients, twice weekly in three patients (32.4%, n = 9). The sustained virological response rate was 100% in the 21 patients who did viral load after treatment. The main adverse events were nausea (10.7%), vomiting (10.7%), dizziness (7.1%), headache (7.1%) and pruritus (7.1%). The glomerular filtration rate was 22.3 ± 5.7 ml/min/1.73 m 2 at the start of treatment, 17.7 ± 4 ml/min/1.73 m 2 at the end of treatment and 20.7 ± 5.3 ml/min/1.73 m 2 three months after treatment.
Conclusion:Treatment with sofosbuvir-containing regimens is effective and well tolerated in patients infected with hepatitis C virus and stage 4 and 5 chronic kidney disease.
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