Effectiveness of fixed-dose combination of paritaprevir, ritonavir, ombitasvir, and dasabuvir in patients with chronic hepatitis C virus infection and chronic kidney diseases: real-life experiences

Eur J Gastroenterol Hepatol. 2019 Apr;31(4):534-539. doi: 10.1097/MEG.0000000000001334.

Abstract

Introduction: Both hepatitis C virus infection (HCV) and chronic kidney disease (CKD) have been comorbid illnesses with increasing morbidity and mortality. The present study was conducted to present real-life experiences about treatment of HCV and CKD with a fixed-dose combination of paritaprevir 150 mg/day, ritonavir 100 mg/day as a booster, ombitasvir 25 mg/day, and dasabuvir 250 mg twice/day, the PROD regimen.

Patients and methods: This was a multicenter, retrospective cohort study. Seventy-five patients with both HCV and CKD were treated with a PROD-based regimen with or without ribavirin. Fifty-three of 75 patients were on maintenance hemodialysis program. Seven patients had compensated liver cirrhosis. The patients with genotype 1a or compensated liver cirrhosis were treated with the PROD regimen and ribavirin in a dose of 200 mg every other day for 12 weeks. The patients with genotype 1b were treated with PROD for 12 weeks. The patients with genotype 4 were treated with a combination of paritaprevir, ritonavir, ombitasvir, and ribavirin 200 mg every other day.

Results: All patients except one were HCV-RNA negative (98.6%) at the end of treatment. One patient had decompensated after the fourth day of therapy. She stopped the treatment, and she was exitus after 2 months. Two patients died of reasons not related to the drugs 2 months after negativity of HCV-RNA. Sustained viral rate 12 weeks after treatment was found in 96% of the patients.

Conclusion: The PROD regimen was very effective and safe for treatment in patients with HCV and CKD who were in stages 4 and 5.

Publication types

  • Multicenter Study

MeSH terms

  • 2-Naphthylamine
  • Adult
  • Aged
  • Aged, 80 and over
  • Anilides / administration & dosage
  • Anilides / therapeutic use
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Carbamates / administration & dosage
  • Carbamates / therapeutic use
  • Cyclopropanes
  • Drug Therapy, Combination
  • Female
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Lactams, Macrocyclic
  • Macrocyclic Compounds / administration & dosage
  • Macrocyclic Compounds / therapeutic use
  • Male
  • Middle Aged
  • Proline / analogs & derivatives
  • Renal Insufficiency, Chronic / complications*
  • Retrospective Studies
  • Ritonavir / administration & dosage
  • Ritonavir / therapeutic use
  • Sulfonamides / administration & dosage
  • Sulfonamides / therapeutic use
  • Sustained Virologic Response
  • Treatment Outcome
  • Uracil / administration & dosage
  • Uracil / analogs & derivatives
  • Uracil / therapeutic use
  • Valine

Substances

  • Anilides
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • Lactams, Macrocyclic
  • Macrocyclic Compounds
  • Sulfonamides
  • ombitasvir
  • Uracil
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • Valine
  • Ritonavir
  • paritaprevir