Sofosbuvir/ledipasvir safety and efficacy for HCV patients with haemodialysis and decompensated cirrhosis: a case series

Abstract

Background Sofosbuvir/ledipasvir (SOF/LDV) combination is very effective against HCV. However, it was until recently approved for use in end-stage renal disease (ESRD), and on haemodialysis. Furthermore, No much data available for SOF/LDV in compensated and decompensated cirrhosis. Aims To assess the effectiveness and side-effects of SOF/LDV in HCV patients with ESRD, on haemodialysis, and have no cirrhosis or have either compensated or decompensated cirrhosis. Methods Data of 21 HCV patients was collected and they were on haemodialysis and had different CTP and were assessed for HCV at end treatment after 12 weeks, and after 12 and 24 weeks of end treatment. Treatment consisted of 90g of SOF/ 400g of LDV once daily. Results The sample contained 16 males and 5 females with mean age of 40.9 years. Three patients had decompensated cirrhosis CTP B, and four chronic hepatitis with minor cirrhotic changes with CTP A. Full follow-up was for only 20 patients and they all had HCV resolved as one patient passed away. Other factors were assessed such as HCV genotypes, but they had the same results with no difference in symptoms development. Conclusion SOF/LDV combination is suggested to be effective even if the patient was on haemodialysis and had compensated, or decompensated cirrhosis without the need of dose adjustment or increase duration with no major complications in patients with HCV 1a, 1b, 4, and 5.