Efficacy and Safety of the Paritaprevir/Ritonavir/Ombitasvir/Dasabuvir Regimen for Chronic Hepatitis C in Hemodialysis Patients

Abstract

Introduction: A higher percentage of sustained virologic response (SVR) has been reported with the introduction of direct-acting antivirals (DAAs) to the treatment of hepatitis C in recent years. However, there are still relatively limited data on the effectiveness and safety of the use of DAAs in hemodialysis patients. The aim of this study was to evaluate the efficacy and safety of chronic hepatitis C treatment with paritaprevir/ritonavir/ ombitasvir and dasabuvir (3D) in hemodialysis patients. Materials and Methods: Hemodialysis patients who were treated with 3D regimen between July 2016 and October 2018 were evaluated retrospectively. Patients coinfected with hepatitis B or human immunodeficiency virus and those with cirrhosis were excluded. Serum hepatitis C virus (HCV) RNA and alanine aminotransferase levels of the patients were recorded after one and three months of therapy. SVR was defined as negative HCV RNA at three months after cessation of HCV treatment. Any drug-related alterations in clinical or laboratory findings during the treatment period were evaluated as side effects. Results: Fifteen patients who were treated with the 3D regimen during the study period were included. Genotype 1b and 1a were detected in 12 and three patients, respectively. Ribavirin was added to treatment for genotype 1a-infected patients. Hemoglobin levels were reduced in two of the three patients who received ribavirin. One patient had macular rash and another patient complained of fatigue. No serious side effects were observed. At the end of treatment, a low level of HCV RNA (63 IU/ml) was detected in only one patient. At the end of treatment, HCV RNA negativity was achieved in 12 out of 13 patients whose HCV RNA quantitation data were available. End-of-treatment success rate was 92%. SVR was achieved in all of the patients at three-months after treatment cessation (100% SVR12). Conclusion: This study shows that the 3D regimen is safe and effective in the treatment of hemodialysis patients infected with hepatitis C.