Butt Nazish, Abbasi Amanullah, Ali Khan M, Ali Muhammad, Mahesar Ghulam B, Haleem Farhan, Manan Abdul
Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Cureus. 2019 Sep 19;11(9):e5702. doi: 10.7759/cureus.5702.
Background Hepatitis C (HCV) infection is the most commonly acquired infection for patients on hemodialysis and is associated with significant morbidity and disease progression. Direct-acting antivirals (DAAs) have revolutionized the management of HCV. However, limited data exist regarding their efficacy in end-stage renal disease (ESRD), especially for patients on dialysis in South Asia. Aims To evaluate the treatment outcomes of patients undergoing hemodialysis with chronic hepatitis C (CHC) on the sofosbuvir (SOF) and daclatasvir (DAC) regimen. Materials and methods All patients who were 18 years or older, diagnosed cases of chronic kidney disease (stage V), and undergoing maintenance hemodialysis were inducted into this study. Active HCV infection was demonstrated by polymerase chain reaction (PCR) HCV ribonucleic acid (RNA) (qualitative). All patients were then treated with a double regimen of SOF (400 mg once daily) and DAC (60 mg once daily) taken per oral for 12 weeks. Response to treatment was assessed at four, 12, and 52 weeks. Results A total of 31 out of 80 patients were inducted into the study over two years. The prevalence of HCV in hemodialysis patients was 38.75%. Sustained virological response (SVR) was achieved by 27 (87.09%) patients at one year. Four (12.90%) patients had a relapse of HCV. There was no deterioration of hepatological status in any of the patients. Overall survival at one year was 93.54%. Conclusion HCV is highly prevalent in patients undergoing hemodialysis. Prompt treatment with SOF and DAC demonstrates a good response, with negligible side effects.
背景 丙型肝炎病毒(HCV)感染是血液透析患者最常见的获得性感染,与显著的发病率和疾病进展相关。直接抗病毒药物(DAAs)彻底改变了HCV的治疗方式。然而,关于其在终末期肾病(ESRD)中的疗效,特别是在南亚透析患者中的数据有限。目的 评估接受慢性丙型肝炎(CHC)血液透析的患者使用索磷布韦(SOF)和达卡他韦(DAC)方案的治疗效果。材料和方法 所有18岁及以上、被诊断为慢性肾病(V期)且正在接受维持性血液透析的患者纳入本研究。通过聚合酶链反应(PCR)检测HCV核糖核酸(RNA)(定性)来证实活动性HCV感染。然后所有患者接受SOF(400mg每日一次)和DAC(60mg每日一次)的联合方案口服治疗12周。在第4、12和52周评估治疗反应。结果 在两年内,80名患者中有31名纳入研究。血液透析患者中HCV的患病率为38.75%。27名(87.09%)患者在一年时实现了持续病毒学应答(SVR)。4名(12.90%)患者出现HCV复发。所有患者的肝脏状况均未恶化。一年时的总生存率为93.54%。结论 HCV在接受血液透析的患者中高度流行。使用SOF和DAC进行及时治疗显示出良好的反应,副作用可忽略不计。