Sofosbuvir Combo Shows Promise for effective treatment of HCV patients with CKD on hemodialysis
Telangana: Hepatitis C virus (HCV) infection has long been a concern for patients undergoing maintenance hemodialysis (MHD) in India, where the prevalence of this condition is notably high. HCV infection is not only associated with a heightened risk of mortality but is also closely linked to cardiovascular diseases. Treating HCV in this vulnerable population, however, has been a challenging task due to the limited availability of recommended directly acting antivirals in the country. Moreover, concerns surrounding the renal elimination of pangenotypic sofosbuvir raised questions about its safety.
A prospective study published in the Journal Of The Association Of Physicians In India by Manisha Sahay and the team conducted between 2019 and 2020 aimed to address these challenges by investigating the treatment outcomes of patients on hemodialysis with HCV infection. The study collected clinical data, including biochemical parameters, viral load, and genotyping, while also noting the results of treatment involving sofosbuvir in combination with velpatasvir or daclatasvir administered over 12 weeks.
- The study, which included 54 hemodialysis patients with HCV, unveiled some compelling findings.
- Genotype 1 emerged as the most prevalent, affecting 75.9% (n = 41) of the participants.
- An impressive 96.29% (n = 52) of the patients achieved sustained virological response (SVR) at the study's conclusion, signalling a successful clearance of the virus from their bodies.
- Even more promising, none of the patients experienced severe side effects necessitating a reduction in treatment doses or discontinuation.
These results indicate that the combination therapy involving sofosbuvir demonstrates a high level of efficacy among dialysis patients, irrespective of their HCV genotype or the presence of cirrhosis. Moreover, this treatment approach requires minimal monitoring, mirroring the successful outcomes observed in non-chronic kidney disease (CKD) patients.
The findings offer hope for patients with HCV infection receiving hemodialysis in India, potentially paving the way for more accessible and effective treatment options in the future. With the threat of HCV significantly reduced, these patients may enjoy improved health and well-being, contributing to an overall better quality of life.
Reference:
Sahay M, Priyashree, Ismal K, et al. Efficacy and Safety of Directly Acting Antivirals in Patients with Hepatitis C Infection on Hemodialysis. J Assoc Physicians India 2023;71(8):25–28. https://www.japi.org/y2648454/efficacy-and-safety-of-directly-acting-antivirals-in-patients-with-hepatitis-c-infection-on-hemodialysis
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