Experience with antiviral agents for treatment of hepatitis C virus infection in hemodialysis patients on the kidney wait list

Abstract

Introduction Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in kidney transplant patients. The ability to establish a sustained viral response before renal transplant is important for these patients. Direct‐acting antiviral agents can increase the sustained viral response in most patients with HCV infection. In this case series, we aimed to determine the efficacy and safety of a combined therapy of ombitasvir, paritaprevir, ritonavir, and dasabuvir with or without ribavirin in patients with HCV genotype 1 infection without cirrhosis and on hemodialysis who were awaiting deceased‐donor kidney transplant. Methods Our study included eight male and two female HCV ribonucleic acid (RNA)‐positive hemodialysis patients (mean age 50.7 ± 15 years, mean hemodialysis duration 14 ± 5.5 years, mean HCV duration 18 ± 3.7 years). Findings Three patients with genotype 1a received oral therapy with 12.5 mg ombitasvir, 150 mg paritaprevir, 7 5 mg ritonavir, and 250 mg dasabuvir plus 200 mg ribavirin for 12 weeks. Seven patients with genotype 1b received 12.5 mg ombitasvir, 150 mg paritaprevir, 75 mg ritonavir, and 250 mg dasabuvir without ribavirin treatment for 12 weeks. The sustained virologic response rate was 100% at 12 weeks after completion of antiviral treatment in both treatment groups. No serious adverse effects were observed in either treatment group. Five patients had constitutional symptoms such as nausea, anorexia, and fatigue. During the treatment period, hemoglobin, white cell blood count, thrombocyte, and ferritin levels were similar to pretreatment levels. Treatment did not affect weekly erythropoietin and monthly intravenous iron treatment doses. Discussion Direct‐acting antiviral agents are safe and effective for generating a sustained viral response in HCV genotype 1‐infected hemodialysis patients on kidney wait lists.

The Efficacy of Paritaprevir/Ritonavir/Ombitasvir/Dasabuvir with or without Ribavirin in Patients with Hepatitis C Undergoing Chronic Haemodialysis: A Single Center Experience

“…In the literature, the most common side effects of PrOD were fatigue and pruritus (9,10,11,12). In our study the most common side effect was pruritus, which was observed in 3 patients.…”

“…After RUBY-I trial was published, SVR rate >95% was observed and eradication of HCV in ESRD patients became much more possible (8). The real-life experiences published after RUBY-I showed that SVR rates were equal to or greater than those reported in RUBY-I trial (9,10,11,12,13).…”

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

“…Torun et al reported that hemoglobin level, white cell blood count, and thrombocyte count were similar to pretreatment levels and SVR12. 16 During treatment, total bilirubin levels were elevated in f ive patients during the f irst two weeks and decreased below normal limits in the first month.…”

“…Patients were divided into two groups according to the genotype; 3/10 were genotype 1a, 7/10 genotype 1b, and the reported SVR 12 rate was 100%. 16 The study published by Etik et al evaluated 30 CHC patients(18 patients with ESRD and 12 kidney transplant recipients). They reported that SVR 12 was 94% of patients in the ESRD group and 92% in the kidney transplant group.…”

Assessing Responsiveness of Elevated Serum Ferritin for Treatment in Chronic Hepatitis C Infected Patients

“…Cases of death and disease have been estimated worldwide, and a larger increase has been associated with infection with the HCV. It has been found that about7 million people normally experience fatal complications from HCV-associatedsigns clinically due to hepatocellular carcinoma (HCC) and cirrhosis each year 16 . The World Health Organization has also identified a cure for HCV infection by treatment with antivirals; though, maximum people who are infecteduninformed of the infection because of the disease asymptomatic nature.…”