Efficacy of Direct-acting Antivirals in Hemodialysis Patients with Chronic Hepatitis C: A Real-life Retrospective Study

Abstract

Objectives: Hepatitis C virus (HCV) infection is common among hemodialysis (HD) patients and is associated with increased morbidity and mortality. New generation direct-acting antiviral (DAA) agents are safe and effective in treatment HCV infection in HD patients. The aim of this a multi-center study was to assess the efficacy of DAAs in HD patients with HCV infection.

Materials and Methods: HD patients with HCV infection followed-up at five centers were included in this retrospective cohort study. Patients demographic and virological characteristics, liver fibrosis status, end of treatment and sustained virologic responses (SVR12) at 12 weeks after treatment were recorded. Treatment of the patients was arranged according to the genotype and drug interactions considering guidelines.

Results: Ninety percent of 20 patients were genotype 1b and were treated for 12 weeks with paritaprevir-ritonavir-ombitasvir-dasabuvir; one patient was genotype 4 and received PrOD + ribavirin (RBV) for 12 weeks; and one patient was genotype 3 and was treated with sofosbuvir + RBV for 24 weeks. HCV-RNA negativity was achieved in all patients at the end of treatment and SVR12 rate was 100%. Significant side effects were not observed in any patients, apart from sleeplessness in one patient and itching in another.

Conclusion: Our real-life data support that new generation DAAs achieve high SVR and are well tolerated in HD patients with HCV. In these patients, intolerance and side effects were not observed, which would otherwise require cessation of the DAA regimen.