Abstract
The prevalence of hepatitis C virus (HCV) infection remains higher in dialysis patients than in the general population, and HCV chronic infection results in significant morbidity and mortality. This negative impact evidences the need of regular screening, fibrosis evaluation, and antiviral treatment with the new direct antiviral agents (DAAs). In dialysis patients, DAAs should be given in all patients with whatever fibrosis stage and whether or not they are candidates for kidney transplantation. The grazoprevir/elbasvir or the paritaprevir/ritonavir, ombitasvir, dasabuvir ± ribavirin combinations reached high sustained virological response (SVR). Sofosbuvir is not recommended in patients with a glomerular filtration rate (GFR) below 30 mL/min. Lower daily doses of sofosbuvir and ribavirin led to disappointing results. Several studies with sofosbuvir plus simeprevir or daclatasvir or ledispasvir reported high SVR and good tolerance, but the optimal dose of sofosbuvir in dialysis patients needs to be clarified. Additional clinical trials of DDAs in late chronic kidney disease (CKD) are definitely needed.
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