Abstract:

Objectives: The aim of this study was to evaluate the success of the paritaprevir/ritonavir/ombitasvir/dasabuvir (PROD), ledipasvir/sofosbuvir (LDV/SOF) and peginterferon (Peg-IFN) alfa-2a in the elimination of chronic hepatitis C virus (HCV) infection in HCV positive hemodialysis patients, and to evaluate the management of concomitant drug-drug interactions in patients receiving direct acting antiviral (DAA). Materials and Methods: The demographic characteristics, comorbid diseases, laboratory data, and treatment regime and duration of 10 patients who were infected with HCV genotype 1 were retrospectively screened from the electronic hospital records. The patients were divided into 3 groups according to the treatment regime: PROD, LDV/SOF and Peg-IFN. Data on virological response, adverse events, and biochemical and hematological parameters during and after therapy were analyzed. Also, concomitant drug use and drug-drug interactions were evaluated in patients receiving DAA regime. Results: The median age was 48 (21-74) years, 5 (50%) of patients were female. 2 patients (20%) received LDV/SOF, 5 (50%) PROD and 3 (30%) Peg-IFN. Six of patients (60%) were HCV treatment-experienced and were failed to previous Peg-IFN therapy. All patients achieved sustained virological response (100%). At the end of the one-year follow-up period, none of patients presented with HCV reactivation, and thus HCV was eliminated from our hemodialysis unit. No patient experienced serious adverse event leading to medication discontinuation during the course of treatment. Drug-drug interactions had to be modified with the treatment initiation in 2 out of 7 patients who received DAA. Conclusion: When multidrug use and comorbidities in hemodialysis patients are considered, multidisciplinary approach led by a nephrologist are very important for increased access to treatment and more effective management of patients.

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