Outcome of sofosbuvir based regimen in chronic hepatitis C patients with chronic kidney diseases on maintenance hemodialysis from western India

Abstract

Introduction: The introduction of direct-acting antiviral (DAA)-based therapies for hepatitis C virus (HCV) has revolutionized the approach to HCV treatment. The data of sofosubvir based regimen in HCV infected Chronic Kidney Diseases (CKD) Patients on maintenance hemodialys (MHD) is not widely available. Our study was aimed to evaluate the effect of sofosbuvir–Ledipasvircombinationregimen in HCV positive CKD patient on MHD. Materials and Methods: Patients aged more than 12 years with HCV RNA positive and on MHD were included. Patients having liver cirrhosis and already started DAAs were excluded. Before starting treatment genotype, viral load routine clinical and laboratory data (CBC, SGPT, S.Albumin, S.Fetoprotein) were collected at baseline and also at 4, 12, and 24weeks during the treatment. All patients irrespective of genotypes were started sofosbuvir 400mg plus Ledipasvir 90 mg combination alternate day for 12 weeks. HCV RNA viral load was assessed at the end of 4, 12 and 24wks.We evaluated early virological response (EVR) at end of 4th weeks, end of treatment response (ETR) at the end of 12 weeks and sustained virological response (SVR) at the end of 24 weeks after initiation of therapy. Results: We had enrolled 210 HCV RNA patients with male (n=166) predominance with mean age of 31.6±10 years. Genotype 1 in 179 (85.2%) and genotype 3 in 31(14.8%) were found. 208 patients (99.03%) had achieved complete response at 12 wks (SVR12). 2 patients (1b,3) did not respond even at 24 wks. None of patient discontinued therapy because of side effects. No significant change in hemoglobin, platelet count and bilirubin. Conclusions: Sofosbuvir-Ledipasvir therapy on alternate day for 12 weeks was found effective therapy for HCV?infected CKD patients on MHD. Keywords: Sofosbuvir, Ledipasvir, HCV treatment, Haemodialysis, Western India.