Case Series of Responders to Sofosbuvir Plus Velpatasvir Based Combination Therapy for Hepatitis C in Chronic Kidney Disease Who are on Maintenance Hemodialysis
Authors/Creators
- 1. Consultant Nephrologist, Associate Professor, Department of General Medicine, SSIMS & RC, Davangere
- 2. Post Graduate Resident, Department of General Medicine, SSIMS & RC, Davangere
- 3. Associate Professor, Department of General Medicine, SSIMS & RC, Davangere
- 4. Professor and Head, Department of General Medicine, SSIMS & RC, Davangere
Description
Hepatitis C Virus (HCV) infection is a major infection worldwide, with 12.5 million people infected in India alone. In hemodialysis undergoing CKD population in specific, the prevalence of HCV is 4.3 – 45 %. It leads to accelerating decline of renal and liver functions causing higher mortality in hemodialysis patients. WHO recommends use of pan-genotypic, direct-acting anti-virals for the treatment of HCV. Sofosbuvir, in combination with other antivirals, led to a significant paradigm change in the treatment of HCV. Sofosbuvir is metabolized in the liver into an active metabolite which is not detected in circulation and an inactive metabolite that is excreted renally. Sofosbuvir and Velpatasvir combination of drugs was given to 10 HCV positive patients with CKD and on hemodialysis for 12 weeks. Viral load, after the completion of the treatment, were undetectable in all the patients. Sofosbuvir-Velpatasvir combination was demonstrated effective and safe in hemodialysis undergoing HCV patients.
Abstract (English)
Hepatitis C Virus (HCV) infection is a major infection worldwide, with 12.5 million people infected in India alone. In hemodialysis undergoing CKD population in specific, the prevalence of HCV is 4.3 – 45 %. It leads to accelerating decline of renal and liver functions causing higher mortality in hemodialysis patients. WHO recommends use of pan-genotypic, direct-acting anti-virals for the treatment of HCV. Sofosbuvir, in combination with other antivirals, led to a significant paradigm change in the treatment of HCV. Sofosbuvir is metabolized in the liver into an active metabolite which is not detected in circulation and an inactive metabolite that is excreted renally. Sofosbuvir and Velpatasvir combination of drugs was given to 10 HCV positive patients with CKD and on hemodialysis for 12 weeks. Viral load, after the completion of the treatment, were undetectable in all the patients. Sofosbuvir-Velpatasvir combination was demonstrated effective and safe in hemodialysis undergoing HCV patients.
Files
IJPCR,Vol15,Issue8,Article6.pdf
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Additional details
Dates
- Accepted
-
2023-07-25
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue8,Article6.pdf
- Development Status
- Active
References
- 1. Li M, Chen J, Fang Y, Li Y, Lin Q. Sofosbuvir-based regimen is safe and effective for Hepatitis C infected patients with stage 4-5 chronic kidney disease: a systemic review and meta-analysis. Virol J. 2019; 16(1):34. 2. World Health Organization. Hepatitis C. Who.int. World Health Organization: WHO; 2018. Available from: https://www.who.int/news-room/factsheets/detail/hepatitis-c 3. Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001 Jul 5;345(1):41– 52. 4. F Fabrizi , B Takkouche, G Lunghi, V Dixit, P Messa, P Martin. The impact of hepatitis C virus infection on survival in dialysis patients: meta-analysis of observational studies. Oct 2007; 17875004. 5. Simplified HCV Treatment* for TreatmentNaive Patients Without Cirrhosis | HCV Guidance [Internet]. www.hcvguidelines.org. Available from: https://www.hcvguidelines.org/treatmentnaive/simplified-treatment. 6. Patients with Renal Impairment | HCV Guidance [Internet].www.hcvguidelines.org. Available from: https://www.hcvguidelines.org/uniquepopulations/renal-impairment. 7. Hung-Yin Liu, Yi-Hung Lin, Pei-Ju Lin. AntiHCV antibody titer highly predicts HCV viremia in patients with hepatitis B virus dualinfection. July 2021; 10.1371/journal.pone.0254028; 34197557. 8. Kirby BJ, Symonds WT, Kearney BP, Mathias AA. Pharmacokinetic, Pharmacodynamic, and Drug-Interaction Profile of the Hepatitis C Virus NS5B Polymerase Inhibitor Sofosbuvir. Clinical Pharmacokinetics. July 2015; 54(7): 677–90. 9. Chikako Monoe,1 Hiroyasu Shimizu,1 Kanae Kitaguchi,2 and Hiraku Funakoshi1. Severe Bradycardia Induced by Sofosbuvir and Amiodarone which Resolved after the Discontinuation of Both Drugs. 2020 Oct; 59(20):2619- 2622 10. Roy P, Patel A, Lole K, Gupta RM, Kumar A, Hazra S. Prevalence and genotyping pattern of hepatitis C virus among patients on maintenance hemodialysis at five centers in Pune, India. Med J Armed Forces India 2019; 75:74- 80.