Sofosbuvir-Velpatasvir Full Dose in Chronic Hepatitis C in End-Stage Renal Disease: An Observational Study from a Himalayan Region

Abstract

Background Treatment of chronic hepatitis C (CHC) in the setting of chronic kidney disease and end-stage renal disease (ESRD) is challenging. Objectives We planned to evaluate the efficacy and safety of full dose of combination of sofosbuvir-velpatasvir in the treatment of CHC in patients with ESRD or those on maintenance hemodialysis. Methods The prospective observational study was conducted in a tertiary care center in North India where all patients with chronic kidney disease (CKD) were assessed. Those with hepatitis C virus (HCV) antibody positivity underwent testing for HCV ribonucleic acid and were treated if eligible. Full dose of sofosbuvir-velpatasvir was administered daily for 12 weeks (or 24 weeks for decompensated liver disease). Results Of the 162 patients (mean age: 43.08 ± 12.08 years, 114 males), 125 were on regular hemodialysis. Twenty-four (15%) had evidence of liver cirrhosis, out of which four patients had evidence of decompensation. One hundred forty-two patients (87.6%) had an early virological response. Most patients, 160 (98.7%), obtained end of therapy viral clearance and sustained virological response at 12 weeks after therapy. Two patients died, and rest of the patients completed therapy. The adverse effects noticed were nausea (20%), vomiting (18%), headache (10%), and weakness (7%). Conclusion A combination of sofosbuvir and velpatasvir is effective and safe in treating CHC in the setting of CKD.