Abstract

Research Article

Safety and efficacy of sofosbuvir based regimen in the treatment of hepatitis C virus infection among hemodialysis patients in Morocco

Mouna Tamzaourte*, Yassir Zajjari, Sanae Berrag, Tarik Adioui, Aziz Aourarh and Driss El Kabbaj

Published: 26 September, 2021 | Volume 5 - Issue 3 | Pages: 077-080

The introduction of a new class of drugs known as direct acting antiviral (DAA) agents represents a revolution in the treatment of hepatitis C virus (HCV) in the general population, as these regimens are associated with higher sustained virological response (SVR) rates and fewer side effects. However, for patients with advanced chronic kidney disease suffering from HVC infection, treatment options including DAA remain limited. The aim of this study is to report our experience on Sofosbuvir (SOF) based regimen in the treatment of HCV in hemodialysis patients.
In this observational study, we included all patients with chronic HCV infection on hemodialysis who were treated with SOF in our Hospital between April 2016 and March 2018. All patients were treated with a combination of 400 mg of SOF three times a week after hemodialysis and of 60 mg of Daclatasvir daily for a total of 12 to 24 weeks.
A total of 20 hemodialysis patients were included in this study. 12 were females and the mean age was 52.1 ± 15.5 years. 11 patients were infected with HCV genotypes 1b. All patients achieved SVR. Clinical and biological tolerance was very good for all patients and none of them had to discontinue treatment because of side effects or developed hepatobiliary and cardiac toxicity. Two patients reported fatigue and another patient reported headaches. However, these symptoms were spontaneously resolved after the end of the treatment.
In Morocco, despite the absence of new DAA combination treatment regimens which are not renally eliminated, our study concludes that SOF based treatment without Ribavirin or Peginterferon was effective and safe with minimal side effects. However, larger studies are still needed in order to validate these results.

Read Full Article HTML DOI: 10.29328/journal.jcn.1001078 Cite this Article Read Full Article PDF

Keywords:

Sofosbuvir; Hepatitis C; Hemodialysis

References

  1. Fabrizi F, Lunghi G, Ganeshan SV, Martin P, Messa P. Hepatitis C virus infection and the dialysis patient. Semin Dial. 2007; 20: 416-422. PubMed: https://pubmed.ncbi.nlm.nih.gov/17897248/
  2. Sekkat S, Kamal N, Benali B, Fellah H, Amazian K, et al. Prevalence of anti-HCV antibodies and seroconversion incidence in five haemodialysis units in Morocco. Nephrol Ther. 2008; 4: 105-110. PubMed: https://pubmed.ncbi.nlm.nih.gov/18272446/
  3. Duseja A, Choudhary NS, Gupta S, Dhiman RK, Chawla Y, et al. Treatment of chronic hepatitis C in end stage renal disease: experience at a tertiary care centre. Tro Gastroenterol. 2012; 33: 189–192.
  4. European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2016. J Hepatol. 2017; 66: 153-194. PubMed: https://pubmed.ncbi.nlm.nih.gov/27667367/
  5. Roth D, Nelson DR, Bruchfeld A, Liapakis A, Silva M, et al. Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase study. Lancet. 2015; 386: 1537–1545. PubMed: https://pubmed.ncbi.nlm.nih.gov/26456905/
  6. Gane E, Lawitz E, Pugatch D, Papatheodoridis G, Bräu N, et al. Glecaprevir and Pibrentasvir in Patients with HCV and Severe Renal Impairment. N Engl J Med. 2017; 377: 1448-1455. PubMed: https://pubmed.ncbi.nlm.nih.gov/29020583/
  7. Kirby BJ, Symonds WT, Kearney BP, Mathias AA. Pharmacokinetic, Pharmacodynamic, and Drug-Interaction Profile of the Hepatitis C Virus NS5B Polymerase Inhibitor Sofosbuvir. Clin Pharmacokinet. 2015; 54: 677-690. PubMed: https://pubmed.ncbi.nlm.nih.gov/25822283/
  8. Desnoyer A, Pospai D, Le MP, Gervais A, Heurgué-Berlot A, et al. Sofosbuvir containing regimen for HCV infection in hemodialysis patients: 400 mg daily or only on the day of hemodialysis. J Hepatol. 2016; 65: 40-47. PubMed: https://pubmed.ncbi.nlm.nih.gov/26952005/
  9. Saxena V, Koraishy FM, Sise ME, Lim JK, Schmidt M, et al. Safety and efficacy of sofosbuvir-containing regimens in hepatitis C-infected patients with impaired renal function. Liver Int. 2016; 36: 807–816. PubMed: https://pubmed.ncbi.nlm.nih.gov/26923436/
  10. Singh T, Guirguis J, Anthony S, Rivas J, Hanouneh IA, et al. Sofosbuvir-based treatment is safe and effective in patients with chronic hepatitis C infection and end stage renal disease: a case series. Liver Int. 2016; 36: 802–806. PubMed: https://pubmed.ncbi.nlm.nih.gov/26824848/
  11. Hundemer GL, Sise ME, Wisocky J, Ufere N, Friedman LS, et al. Use of sofosbuvir-based direct-acting antiviral therapy for hepatitis C viral infection in patients with severe renal insufficiency. Infect Dis (Lond). 2015; 47: 924-929. PubMed: https://pubmed.ncbi.nlm.nih.gov/26365684/
  12. Gevers TJG, Burger D, Schipper-Reintjes E, Kooistra MP, Richter C. Full-dose sofosbuvir and daclatasvir for chronic hepatitis C infection in haemodialysis patients. Neth J Med. 2016; 74: 225-227. PubMed: https://pubmed.ncbi.nlm.nih.gov/27323683/
  13. Choudhary NS, Kumar A, Bodh V, Bansal SB, Sharma R, et al. Efficacy and safety of sofosbuvir-based regimens in chronic hepatitis C patients on dialysis. Indian J Gastroenterol. 2017; 36: 113-116. PubMed: https://pubmed.ncbi.nlm.nih.gov/28281085/
  14. Nazario HE, Ndungu M, Modi AA. Sofosbuvir and Simeprevir in Hepatitis C genotype 1- patients with End-Stage Renal Disease on hemodialysis or GFR <30mL/min. Liver Int. 2016; 36: 798-801. PubMed: https://pubmed.ncbi.nlm.nih.gov/26583882/
  15. Dumortier J, Bailly F, Pageaux GP, Vallet-Pichard A, Radenne S, et al. Sofosbuvir-based antiviral therapy in hepatitis C virus patients with severe renal failure. Nephrol Dial Transplant. 2017; 32: 2065-2071. PubMed: https://pubmed.ncbi.nlm.nih.gov/27760839/
  16. Agarwal SK, Bagchi S, Yadav RK. Hemodialysis patients trated for hepatits C using a sofosbuvir containing regimen/ Kidney International Reports. 2017; 2: 831–835. PubMed: https://pubmed.ncbi.nlm.nih.gov/29270489/
  17. Cornpropst MT, Denning JM, Clemons D, Marbury T. The effect of renal impairment and end stage renal disease on the single-dose pharmacokinetics of PSI-7977. J Hepatol. 2012; 56: S433.

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