Sofosbuvir-based treatment is safe and effective in Indian hepatitis C patients on maintenance haemodialysis: A retrospective study

Autor:	Rajan Ravichandran, B Balaji Kirushnan, Melvin Martin, NK Ganesh Prasad, Mohammed Shujauddin Akhil, Kanakaraj Arumugam
Rok vydání:	2018
Předmět:	Ledipasvir medicine.medical_specialty Daclatasvir Sofosbuvir Hepatitis C virus 030232 urology & nephrology medicine.disease_cause Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Medicine business.industry Ribavirin virus diseases General Medicine Hepatitis C medicine.disease Regimen chemistry Nephrology 030211 gastroenterology & hepatology business Viral load medicine.drug
Zdroj:	Nephrology. 23:446-452
ISSN:	1320-5358
DOI:	10.1111/nep.13050
Popis:	Aim This study evaluates the safety and efficacy of direct-acting antivirals (DAAs) including sofosbuvir, ledipasvir and daclatasvir in patients with hepatitis C viraemia who were on maintenance haemodialysis. Methods Data on patients who received sofosbuvir and ribavirin were analysed. Patients who experienced treatment failure with the above regimen received sofosbuvir and ledipasvir for infection with hepatitis C virus (HCV) genotype 1. Those having HCV genotype 3 infection received sofosbuvir and daclatasvir. All treatment regimens were of 12 weeks duration. Side-effects were investigated. The HCV viral load was determined by RT-PCR at 4,16 and 24 weeks after the initiation of therapy; haemoglobin levels and liver function tests were monitored at regular intervals during therapy. Results Of the 22 subjects initially treated with sofosbuvir and ribavirin, 72.72% attained sustained virologic response at 12 weeks (SVR12). Four patients experienced treatment failure and received genotype specific therapy. Patients with HCV genotype one received sofosbuvir with ledipasvir. One patient with HCV genotype 3 infection received sofosbuvir and daclatasvir. All of them attained SVR12. A statistically significant reduction in the median serum glutamic-oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT) were observed from the baseline until the end of treatment. Anaemia was observed in 45% of patients receiving ribavirin. Conclusions Our study demonstrates that sofosbuvir-based therapy is efficacious for HCV viraemia in patients on maintenance haemodialysis. The therapy was found to be reasonably safe with no major adverse effects noted with the use of sofosbuvir, ledipasvir or daclatasvir. However, larger studies are needed to validate our results.
Databáze:	OpenAIRE
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