Outcome of Treatment for Hepatitis C Infection in Hemodialysis Patients with Direct-Acting Second-Generation anti-HCV Drugs at Azzawiyah Kidney Hospital, Libya

Abstract

Background: Hepatitis C virus infection is the most common viral infection in patients on hemodialysis and is a leading cause of chronic liver disease in end-stage renal disease patients. The main aim of this study was to review the outcome of the treatment of HCV in hemodialysis patients with second-generation anti-HCV drugs at Azzawiyah Kidney Hospital. Patients and Methods: Thirty-two hemodialysis patients with proven HCV infection (HCV-polymerase chain reaction-positive) received antiviral treatment for 12 weeks and followed up for 12 months, with liver function tests and repeated HCV-RNA. The primary outcome was the proportion of patients who achieved sustained virological response at 12 weeks posttreatment (SVR-12). Results: 32 patients (32/280, 11.4%) out of the total number of (280) regular hemodialysis patients were proven to have HCV infection, during the period from December 2016 to December 2019. The median age of the study population was 53.5 ± 12 years, and 55% were females. The median duration of dialysis was 9.6 years (range 3–25 years). The causes of chronic kidney disease were diabetes mellitus at 43.7%, hypertension at 25.5%, adult polycystic kidney disease at 12.5%, and chronic glomerulonephritis at 9.3%. Twenty nine (29/32) patients received antiviral treatment with sofosbuvir/daclatasvir (SOF/DLC) and (3/32) patients with elbasvir and grazoprevir (ERB/GZR). 96.9% of SOF/DLC achieved SVR 12 and 100% of EBR/GSR by the end of the treatment, only one patient (3.1 %) failed to achieve it. No significant side effects were reported for the treatment drugs. Conclusion: This study confirmed that the treatment of hemodialysis patients with chronic hepatitis C infection with second-generation anti-HCV drugs is safe and has elicited a sustained negative virological response.