Abstract: SA-PO991
Efficacy and Tolerability of Sofosbuvir and Daclatasvir for Treatment of Hepatitis C Genotype 3 in Patients Undergoing Maintenance Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Author
- Cheema, Shafiq ur Rehman, Allama Iqbal Medical College, Lahore, Pakistan
Background
There is paucity of data using direct anti-virals agents (DAA) in patients on maintenance hemodialysis infected with HCV-genotype 3.Sofosbuvir (SOF) based therapy leads to high rates of SVR with few side effects (18), however its use is restricted to patients with an eGFR of ≥ 30 ml/min per 1.73 m2 .The aim of this study is to evaluate DAA therapy in patients infected with HCV-genotype 3 on maintenance hemodialysis (MHD)
Methods
In this prospective open label, parallel,non-randomized interventiona trial, group1 received 400 mg daily sofosbuvir/ 60 mg daily daclatasvir; while group 2 received thrice a week 400 mg sofosbuvir/ daily 60 mg daclatasvir for 12 weeks. Patients with compensated cirrhosis received therapy for 24 weeks.Patients were classified as having compensated cirrhosis based on clinical data, Child-Pugh score and abdominal imaging.Fibro Scan and EGD were performed when indicated. Baseline data were obtained before, during and after therapy. HCV viral load was assessed at week 4, 8, at end of therapy and 12 weeks after treatment.The primary end point was acheivment of SVR. SVR was defined as undetectable viral load 12 weeks after completion of therapy.
Results
Eighteen patients were enrolled in each group. Mean age was 47.22+14.17 in group 1 and 53.89+14.11 in group 2. Mean duration of known infection was 4.61+1.84 years in group 1 and 3.55+1.92 years in group 2. Four (22.2%) patients in group 1, while six (33.3%) in group 2 had cirrhosis. Genotype 3 was most common with 12 (66.6%) in group 1, and 11 (61.1%) in group 2. Three patients (16.6%) had prior HCV treatment in group 1, while 02 (11.1%) in group 2. Three patients in group 1 left treatment (non-compliance) while one left in group 2 (adverse effects = skin rash). All patients in both groups achieved undetectable viral load at 12th week. Overall 29/32 (90.62%) patients achieved SVR (group 1= 15/15 or 100%; group 2= 14/17 or 82.35%).Three patients in group 2 who did not achieved SVR were all infected by genotype 1 and two of them had previously received treatment with interferon.
Conclusion
DAA therapy using sofosbuvir and declatsavir is highly effective and tolerable in patients with HCV genotype 3 undergoing maintenance hemodialysis, especially when given daily.Decreasing the dose or frequency of SOF may lead to decreased SVR or higher relapses.