Effectiveness and safety of glecaprevir and pibrentasvir for hemodialysis patients with hepatitis C virus infection at a single center

Abstract

Background/Aims: Glecaprevir/pibrentasvir (GLE/PIB) is a pan-genotypic regimen for the treatment of hepatitis B virus (HCV) infection. GLE and PIB are direct acting antiviral (DAA) agents that can be used for patients with chronic renal failure who are on hemodialysis (HD) and those with HCV genotype 2 infections. Here, we report the usefulness and safety of GLE/PIB in 13 hemodialysis (HD) patients with HCV infection. Material and Methods: The subjects comprised patients with genotype 1 and 2 (six each) and one unknown genotype patient in whom GLE/PIB therapy was introduced by December 2018. The mean age was 69.2 (59-78) years (seven men and six women). The mean HCV RNA amount prior to treatment initiation was 4.81 (2.1-6.5). The administration periods were 8 and 12 weeks (n = 9 and 4, respectively). Results: Twelve patients received all the doses orally while an increase in total bilirubin (T-BIL) caused administration to be discontinued in one patient. HCV RNA at week 4 after treatment initiation became undetectable in 11 (91.6%) of the 12 patients. All patients achieved rapid viral response (RVR). Concerning adverse effects, although itching occurred in three (25%) patients, the symptom improved following administration of oral medication and the treatment was able to be continued. Conclusion: The results suggest that GLE/PIB can also be safely administered to HD patients. However, the usefulness and safety need to be further studied by examining more cases.