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.
Keywords
hepatitis C - cirrhosis - chronic kidney disease - end-stage renal disease - direct
acting antiviral
