Response to direct-acting antiviral agents in chronic hepatitis C patients with end-stage renal disease: a clinical experience

Rev Assoc Med Bras (1992). 2019 Dec;65(12):1470-1475. doi: 10.1590/1806-9282.65.12.1470.

Abstract

Objective: The recent development of direct-acting antiviral agents (DAAs) has dramatically changed the treatment of chronic hepatitis C, and interferon-based regimes have become a poor treatment choice in clinical practice. Today DAAs offer shorter, well-tolerated, highly effective curative therapies. This study aimed to evaluate the effectiveness and safety of DAAs in patients with end-stage renal disease and HCV genotype 1 infection in real clinical practice.

Methods: Thirty-six patients who attended our clinic, were diagnosed with chronic hepatitis C (CHC), undergoing hemodialysis, and fulfilled the criteria of age >18 years, genotype 1 infection, with a detectable HCV RNA level were considered for the study. Patients with GT1a infection received OBV/PTV/r plus DSV plus RBV for 12 weeks; GT1b infected patients received this regimen without RBV for 12 weeks.

Results: The study was conducted on 33 patients. The mean age was 52.30 ±13.77 years, and 70 % of them were male. By the fourth week of treatment, HCV RNA levels decreased below 15 IU/ml in all patients. Sustained virologic response (SVR) 12 rate was 100%. Nine patients had side effects during treatment. Of the patients with side effects, 89.9% were in group 1a and 11.1% in group 1b.

Conclusion: In this study, treatment with OBV/PTV/r and DSV with or without RBV resulted in high rates of sustained virologic response in HCV GT1-infected patients with end-stage renal disease (ESRD). SVR was achieved in all patients with few side effects.

Publication types

  • Evaluation Study

MeSH terms

  • 2-Naphthylamine
  • Adult
  • Aged
  • Anilides / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Carbamates / therapeutic use
  • Cyclopropanes
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepacivirus / drug effects
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Kidney Failure, Chronic / virology*
  • Lactams, Macrocyclic
  • Macrocyclic Compounds / therapeutic use
  • Male
  • Middle Aged
  • Proline / analogs & derivatives
  • RNA, Viral / blood
  • Ribavirin / therapeutic use
  • Ritonavir / therapeutic use
  • Statistics, Nonparametric
  • Sulfonamides / therapeutic use
  • Sustained Virologic Response
  • Time Factors
  • Treatment Outcome
  • Uracil / analogs & derivatives
  • Uracil / therapeutic use
  • Valine
  • Young Adult

Substances

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