World Congress of Gastroenterology

WCOG 2019


 
Efficacy and Safety of Sofosbuvir Based Antiviral Therapy for chronic hepatitis C infection in patients with advanced chronic kidney disease
AHMAD BABAR 1 SHAHID RASOOL 1

1- MADINA TEACHING HOSPITAL
 
Background/Aims:

 The chronic Hepatitis C infection in patients with chronic kidney disease not only accelerates the renal deterioration but also adversely effects morbidity and mortality in patients on hemodialysis and renal transplant. In advanced CKD i.e G4-G5 and G5D (on dialysis) the selection of DAA depends upon degree of renal damage and Genotype of HCV infection. The aim of this study was to evaluate the efficacy and adverse effect profile of Sofosbuvir based DAA in patients with advanced CKD. 

Materials and Methods:

 It is a Quasi Experimental study, conducted from January 2016 to June 2018. Chronic hepatitis C patients with or without cirrhosis having advance CKD (eGFR < 30 ml/min per 1.73 m2) and/or on dialysis were enrolled. End points were documentation of SVR 12 and adverse effects. Only Sofosbuvir based regimens were used with only dose modification for Ribavirin was done according to the tolerance of the patients. 

Results:

 A total of 86 patients with median age 53 years, 37 patients were on maintenance dialysis and 49 were not on dialysis with eGFR < 30 ml/min per 1.73m2. Adverse effect profile was as follows insomnia 14%, headache 11% and anemia 7%. Mean eGFR and creatinine before and after treatment remained the same. Virological response was checked at 4 weeks after start of therapy, at the end of therapy (92.68%) and at 12 weeks after therapy (90.24%). Only 2 patients relapsed both were on dialysis thrice weekly.

Conclusion:

 In conclusion, we state that all Sofosbuvir based regimens used for the treatment of chronic hepatitis C in patients with end stage renal disease are effective as well as have low adverse effect profile making them well tolerated. A close follow up in such patients is advised especially to monitor hemoglobin levels and renal functions.

Keywords:

 Sofosbuvir, hepatitis C, chronic renal failure