SAFETY AND EFFICACY OF DIRECTLY ACTING ANTIVIRAL AGENTS IN CHRONIC HEPATITIS C INFECTED HEMODIALYSIS DEPENDENT PATIENTS: A SINGLE CENTER CROSS-SECTIONAL STUDY
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Keywords
Chronic HCV infection, end stage renal disease, hemodialysis, direct acting anti-viral therapy
Abstract
Chronic Hepatitis C virus infection is a matter of universal health concern, more so in a third world
country like Pakistan with significant disease prevalence. Patients with end stage renal disease
(ESRD) who are on maintenance hemodialysis are at an increased risk for developing this infection
due to various factors. The introduction of direct acting anti-viral (DAA) therapy for hepatitis C has
simplified treatment. However, challenges related to drug clearance and ribavirin induced anemia
persist in patients with ESRD. The aim of this study was to assess the efficacy and safety of DAA
therapy in chronic HCV patients requiring maintenance hemodialysis. 73 patients were analyzed,
who received a 12-week course of sofosbuvir and velpatasvir (without ribavirin). Sustained
virological response at week 12 (SVR-12) was achieved in 97.3% of the patients, equivalent to cure.
No treatment related side effects were noted in 40% of the patients, while remaining patients
experienced mild adverse effects not requiring treatment interruption or withdrawal. Hence, our
study proved that DAA therapy was both effective and safe in our patients with ESRD and
simultaneous chronic HCV infection.
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Sohail Hussain
MBBS, FCPS, MACG, Assistant Professor, Consultant Gastroenterologist and Hepatologist, Clinical Coordinator for Postgraduate studies, Ziauddin University Karachi, Pakistan
Faiza Nafees Khan
MBBS, FCPS-Nephrology, MASN, Assistant Professor/Consultant Nephrologist, Department of Nephrology, Clinical Coordinator for Undergraduate Studies and Internship Programme for MBBS, Ziauddin University Hospital Karachi, Pakistan
S. M. Qamrul Arfin
Assistant Professor, Consultant Gastroenterologist and Hepatologist Ziauddin University Hospital,
Karachi, Pakistan
Muhammad Kamran
MBBS, FCPS (Gastroenterology), Assistant Professor, Fazaia Ruth Pfau Medical College and Teaching Hospital, Karachi, Pakistan
Sumbal Nasir Mahmood
Diplomat American Board of Internal Medicine, Diplomat American Board of Nephrology Professor/Consultant Nephrologist/ Head of Department, Department of Nephrology, Ziauddin University Hospital, Karachi, Pakistan
Imtiaz Begum
MBBS, MRCP, Associate Professor of Medicine, Ziauddin University Karachi, Pakistan