Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients
Hepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting a...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2017-03-01
|
| Series: | Nefrología (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2013251417300822 |
| _version_ | 1818317979536850944 |
|---|---|
| author | Soraya Abad Almudena Vega Diego Rincón Eduardo Hernández Evangelina Mérida Nicolás Macías Raquel Muñoz Mónica Milla Jose Luño Juan Manuel López-Gómez |
| author_facet | Soraya Abad Almudena Vega Diego Rincón Eduardo Hernández Evangelina Mérida Nicolás Macías Raquel Muñoz Mónica Milla Jose Luño Juan Manuel López-Gómez |
| author_sort | Soraya Abad |
| collection | DOAJ |
| description | Hepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting antivirals (DAAs). The aim of this study is to retrospectively analyse the current prevalence of HCV infection and efficacy and safety results with different DAA regimens in the haemodialysis population of 2 hospital areas.
This is a multicentre, retrospective and observational study in which HCV antibodies were analysed in 465 patients, with positive antibody findings in 54 of them (11.6%). Among these, 29 cases (53.7%) with genotypes 1 and 4 were treated with different DAA regimens, including combinations of paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir and ledipasvir, with/without ribavirin. Mean age was 53.3 ± 7.9 years, 72.4% of patients were male and the most important aetiology of chronic kidney disease involved glomerular abnormalities. In 100% of cases, a sustained viral response was achieved after 24 weeks, regardless of DAA regimen received. Adverse effects were not relevant and no case required stopping treatment. In 15 cases, ribavirin was combined with the DAA. In these cases, the most significant adverse effect was anaemic tendency, which was reflected in the increase of the dose of erythropoietin stimulating agents, although none required transfusions.
In summary, we conclude that new DAAs for the treatment of HCV in haemodialysis patients are highly effective with minimal adverse effects; it is a very important advance in HCV management. These patients are therefore expected to have a much better prognosis than they have had until very recently. |
| first_indexed | 2024-12-13T09:45:56Z |
| format | Article |
| id | doaj.art-04a426ae08154a3d8ef3e0f793df5598 |
| institution | Directory Open Access Journal |
| issn | 2013-2514 |
| language | English |
| last_indexed | 2024-12-13T09:45:56Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología (English Edition) |
| spelling | doaj.art-04a426ae08154a3d8ef3e0f793df55982022-12-21T23:52:04ZengElsevierNefrología (English Edition)2013-25142017-03-0137215816310.1016/j.nefroe.2017.04.010Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patientsSoraya Abad0Almudena Vega1Diego Rincón2Eduardo Hernández3Evangelina Mérida4Nicolás Macías5Raquel Muñoz6Mónica Milla7Jose Luño8Juan Manuel López-Gómez9Servicio de Nefrología, Hospital Universitario Gregorio Marañón, Madrid, SpainServicio de Nefrología, Hospital Universitario Gregorio Marañón, Madrid, SpainServicio de Aparato Digestivo, Hospital Universitario Gregorio Marañón, Madrid, SpainServicio de Nefrología. Hospital 12 de Octubre, Madrid, SpainServicio de Nefrología. Hospital 12 de Octubre, Madrid, SpainServicio de Nefrología, Hospital Universitario Gregorio Marañón, Madrid, SpainServicio de Medicina del Aparato Digestivo, Hospital 12 de Octubre, Madrid, SpainServicio de Nefrología. Hospital 12 de Octubre, Madrid, SpainServicio de Nefrología, Hospital Universitario Gregorio Marañón, Madrid, SpainServicio de Nefrología, Hospital Universitario Gregorio Marañón, Madrid, SpainHepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting antivirals (DAAs). The aim of this study is to retrospectively analyse the current prevalence of HCV infection and efficacy and safety results with different DAA regimens in the haemodialysis population of 2 hospital areas. This is a multicentre, retrospective and observational study in which HCV antibodies were analysed in 465 patients, with positive antibody findings in 54 of them (11.6%). Among these, 29 cases (53.7%) with genotypes 1 and 4 were treated with different DAA regimens, including combinations of paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir and ledipasvir, with/without ribavirin. Mean age was 53.3 ± 7.9 years, 72.4% of patients were male and the most important aetiology of chronic kidney disease involved glomerular abnormalities. In 100% of cases, a sustained viral response was achieved after 24 weeks, regardless of DAA regimen received. Adverse effects were not relevant and no case required stopping treatment. In 15 cases, ribavirin was combined with the DAA. In these cases, the most significant adverse effect was anaemic tendency, which was reflected in the increase of the dose of erythropoietin stimulating agents, although none required transfusions. In summary, we conclude that new DAAs for the treatment of HCV in haemodialysis patients are highly effective with minimal adverse effects; it is a very important advance in HCV management. These patients are therefore expected to have a much better prognosis than they have had until very recently.http://www.sciencedirect.com/science/article/pii/S2013251417300822HCV infectionDirect-acting antiviralsHaemodialysis |
| spellingShingle | Soraya Abad Almudena Vega Diego Rincón Eduardo Hernández Evangelina Mérida Nicolás Macías Raquel Muñoz Mónica Milla Jose Luño Juan Manuel López-Gómez Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients Nefrología (English Edition) HCV infection Direct-acting antivirals Haemodialysis |
| title | Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients |
| title_full | Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients |
| title_fullStr | Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients |
| title_full_unstemmed | Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients |
| title_short | Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients |
| title_sort | effectiveness of direct acting antivirals in hepatitis c virus infection in haemodialysis patients |
| topic | HCV infection Direct-acting antivirals Haemodialysis |
| url | http://www.sciencedirect.com/science/article/pii/S2013251417300822 |
| work_keys_str_mv | AT sorayaabad effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT almudenavega effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT diegorincon effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT eduardohernandez effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT evangelinamerida effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT nicolasmacias effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT raquelmunoz effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT monicamilla effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT joseluno effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients AT juanmanuellopezgomez effectivenessofdirectactingantiviralsinhepatitiscvirusinfectioninhaemodialysispatients |