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Published in: International Urology and Nephrology 9/2019

01-09-2019 | Ribavirin | Nephrology - Original Paper

Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality

Authors: Ahmed Yahia Elmowafy, Hanzada Mohamed El Maghrabi, Khaled Farouk Eldahshan, Ayman Fathi Refaie, Mohammed Adel Elbasiony, Yasser Elsayed Matter, Hazem Hamed Saleh, Gamal Elsayed Shiha, Lionel Rostaing, Mohamed Adel Bakr

Published in: International Urology and Nephrology | Issue 9/2019

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Abstract

Background and aims

New direct-acting antiviral drugs have become the corner-stone treatment for HCV infection: they show promising results with accepted side-effects and low dropout rates. One of the available regimens is paritaprevir/ombitasvir/ritonavir (PTV/OMV/RTV). Our aim was to study the efficacy and safety of this drug regimen among HCV-positive hemodialysis patients.

Methods

This prospective single-center study was performed in the Urology and Nephrology Center, Mansoura University, Egypt. Ninety-six maintenance hemodialysis patients were screened for HCV antibodies. Positive results were found in 46 patients (47.9%). HCV PCR was assessed in all HCV-antibody-positive patients; positive results were found positive for 38 (82%); all patients were HCV genotype 4. Four patients were excluded due to advanced liver cirrhosis, liver malignancy, or metastatic breast cancer. Thirty-four patients were prescribed PTV/OMV/RTV for 3 months to treat HCV.

Results

Mean age was 43.2 ± 11.9 years. Most patients were male (67.6%). There was a rapid response to treatment: HCV PCR became negative by 4 weeks after starting treatment. By 12 and 24 weeks post-DAA therapy, there was a sustained viral response (SVR 12, SVR 24) in 100% of patients with improved liver-enzyme levels.

Conclusion

The PTV/OMV/RTV regimen was safe and effectively treated Egyptian HCV-positive genotype-4 hemodialysis patients.
Literature
1.
go back to reference Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H (2014) Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 61:S45–S57CrossRefPubMed Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H (2014) Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 61:S45–S57CrossRefPubMed
2.
go back to reference Wantuck JM, Ahmed A, Nguyen MH (2014) Review article. The epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6. Aliment Pharmacol Ther 39:137–147CrossRefPubMed Wantuck JM, Ahmed A, Nguyen MH (2014) Review article. The epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6. Aliment Pharmacol Ther 39:137–147CrossRefPubMed
3.
go back to reference Grgurević I, Vince A, Buljevac M, Banić M, Jeren-Strujić B, Kes P, Kujundzić M, Leko N, Lukić IK, Slavicek J (2006) Efficacy of interferon-alpha in the treatment of chronic hepatitis C in dialysis patients: two therapeutic protocols compared. Nephron Clin Pract 103(1):c8–c11CrossRefPubMed Grgurević I, Vince A, Buljevac M, Banić M, Jeren-Strujić B, Kes P, Kujundzić M, Leko N, Lukić IK, Slavicek J (2006) Efficacy of interferon-alpha in the treatment of chronic hepatitis C in dialysis patients: two therapeutic protocols compared. Nephron Clin Pract 103(1):c8–c11CrossRefPubMed
4.
go back to reference Fabrizi F, Dixit V, Messa P, Martin P (2008) Interferon monotherapy of chronic hepatitis C in dialysis patients: meta-analysis of clinical trials. J Viral Hepat 15(2):79–88PubMed Fabrizi F, Dixit V, Messa P, Martin P (2008) Interferon monotherapy of chronic hepatitis C in dialysis patients: meta-analysis of clinical trials. J Viral Hepat 15(2):79–88PubMed
5.
go back to reference Gordon CE, Uhlig K, Lau J, Schmid CH, Levey AS, Wong JB (2008) Interferon treatment in hemodialysis patients with chronic hepatitis C virus infection: a systematic review of the literature and meta-analysis of treatment efficacy and harms. Am J Kidney Dis 51(2):263–277CrossRefPubMed Gordon CE, Uhlig K, Lau J, Schmid CH, Levey AS, Wong JB (2008) Interferon treatment in hemodialysis patients with chronic hepatitis C virus infection: a systematic review of the literature and meta-analysis of treatment efficacy and harms. Am J Kidney Dis 51(2):263–277CrossRefPubMed
7.
go back to reference Polepally AR, Badri PS, Eckert D, Mensing S, Menon RM (2017) Effects of mild and moderate renal impairment on ombitasvir, paritaprevir, ritonavir, dasabuvir, and ribavirin pharmacokinetics in patients with chronic HCV infection. Eur J Drug Metab Pharmacokinet 42(2):333–339CrossRefPubMed Polepally AR, Badri PS, Eckert D, Mensing S, Menon RM (2017) Effects of mild and moderate renal impairment on ombitasvir, paritaprevir, ritonavir, dasabuvir, and ribavirin pharmacokinetics in patients with chronic HCV infection. Eur J Drug Metab Pharmacokinet 42(2):333–339CrossRefPubMed
8.
go back to reference Pockros PJ, Reddy KR, Mantry PS, Cohen E, Bennett M, Sulkowski MS, Bernstein DE, Cohen DE, Shulman NS, Wang D, Khatri A, Abunimeh M, Podsadecki T, Lawitz E (2016) Efficacy of direct-acting antiviral combination for patients with hepatitis c virus genotype 1 infection and severe renal impairment or end-stage renal disease. Gastroenterology 150(7):1590–1598CrossRefPubMed Pockros PJ, Reddy KR, Mantry PS, Cohen E, Bennett M, Sulkowski MS, Bernstein DE, Cohen DE, Shulman NS, Wang D, Khatri A, Abunimeh M, Podsadecki T, Lawitz E (2016) Efficacy of direct-acting antiviral combination for patients with hepatitis c virus genotype 1 infection and severe renal impairment or end-stage renal disease. Gastroenterology 150(7):1590–1598CrossRefPubMed
9.
go back to reference European Association for the Study of the Liver (2017) EASL recommendations on treatment of hepatitis C 2016. J Hepatol 66(1):153CrossRef European Association for the Study of the Liver (2017) EASL recommendations on treatment of hepatitis C 2016. J Hepatol 66(1):153CrossRef
10.
go back to reference Sperl J, Frankova S, Kreidlova M, Merta D, Tothova M, Spicak J (2017) Combination of sofosbuvir and daclatasvir in the treatment of genotype 3 chronic hepatitis C virus infection in patients on maintenance hemodialysis. Ther Clin Risk Manag 13:733–738CrossRefPubMedPubMedCentral Sperl J, Frankova S, Kreidlova M, Merta D, Tothova M, Spicak J (2017) Combination of sofosbuvir and daclatasvir in the treatment of genotype 3 chronic hepatitis C virus infection in patients on maintenance hemodialysis. Ther Clin Risk Manag 13:733–738CrossRefPubMedPubMedCentral
11.
go back to reference Sato K, Chayama K, Alves K, Toyoda H, Suzuki F, Kato K, Rodrigues L Jr, Zhang X, Setze C, Pilot-Matias T, Burroughs M, Redman R, Kumada H (2017) Randomized phase 3 trial of ombitasvir/paritaprevir/ritonavir and ribavirin for hepatitis c virus genotype 2-infected Japanese patients. Adv Ther 34(6):1449–1465CrossRefPubMed Sato K, Chayama K, Alves K, Toyoda H, Suzuki F, Kato K, Rodrigues L Jr, Zhang X, Setze C, Pilot-Matias T, Burroughs M, Redman R, Kumada H (2017) Randomized phase 3 trial of ombitasvir/paritaprevir/ritonavir and ribavirin for hepatitis c virus genotype 2-infected Japanese patients. Adv Ther 34(6):1449–1465CrossRefPubMed
12.
go back to reference Suda G, Furusyo N, Toyoda H, Kawakami Y, Ikeda H, Suzuki M, Arataki K, Mori N, Tsuji K, Katamura Y, Takaguchi K, Ishikawa T, Tsuji K, Shimada N, Hiraoka A, Yamsaki S, Nakai M, Sho T, Morikawa K, Ogawa K, Kudo M, Nagasaka A, Furuya K, Yamamoto Y, Kato K, Ueno Y, Iio E, Tanaka Y, Kurosaki M, Kumada T, Chayama K, Sakamoto N (2017) Daclatasvir and asunaprevir in hemodialysis patients with hepatitis C virus infection: a nationwide retrospective study in Japan. J Gastroenterol 53(1):119–128CrossRefPubMed Suda G, Furusyo N, Toyoda H, Kawakami Y, Ikeda H, Suzuki M, Arataki K, Mori N, Tsuji K, Katamura Y, Takaguchi K, Ishikawa T, Tsuji K, Shimada N, Hiraoka A, Yamsaki S, Nakai M, Sho T, Morikawa K, Ogawa K, Kudo M, Nagasaka A, Furuya K, Yamamoto Y, Kato K, Ueno Y, Iio E, Tanaka Y, Kurosaki M, Kumada T, Chayama K, Sakamoto N (2017) Daclatasvir and asunaprevir in hemodialysis patients with hepatitis C virus infection: a nationwide retrospective study in Japan. J Gastroenterol 53(1):119–128CrossRefPubMed
13.
go back to reference Akhil MS, Kirushnan B, Martin M, Arumugam K, Ganesh Prasad NK, Ravichandran R (2018) Sofosbuvir-based treatment is safe and effective in Indian hepatitis C patients on maintenance haemodialysis: a retrospective study. Nephrology (Carlton) 23(5):446–452CrossRef Akhil MS, Kirushnan B, Martin M, Arumugam K, Ganesh Prasad NK, Ravichandran R (2018) Sofosbuvir-based treatment is safe and effective in Indian hepatitis C patients on maintenance haemodialysis: a retrospective study. Nephrology (Carlton) 23(5):446–452CrossRef
14.
go back to reference Morisawa N, Koshima Y, Kuriyama S, Dolla G, Payré C, Jourde-Chiche N, Van de Logt AE, Booth C, Rigby E, Lonnbro-Widgren J, Nystrom J, Mariat C, Cui Z, Wetzels JFM, Ghiggeri G, Beck LH Jr, Ronco P, Debiec H, Lambeau G (2017) Effectiveness of a fixed combination formula of ombitasvir/paritaprevir/ritonavir for hepatitis C virus infection in patients on maintenance haemodialysis. Nephrology 22(7):562–565CrossRefPubMed Morisawa N, Koshima Y, Kuriyama S, Dolla G, Payré C, Jourde-Chiche N, Van de Logt AE, Booth C, Rigby E, Lonnbro-Widgren J, Nystrom J, Mariat C, Cui Z, Wetzels JFM, Ghiggeri G, Beck LH Jr, Ronco P, Debiec H, Lambeau G (2017) Effectiveness of a fixed combination formula of ombitasvir/paritaprevir/ritonavir for hepatitis C virus infection in patients on maintenance haemodialysis. Nephrology 22(7):562–565CrossRefPubMed
15.
go back to reference Lawitz Eric et al (2019) Efficacy and safety of ombitasvir/paritaprevir/ritonavir in patients with hepatitis C virus genotype 1 or 4 infection and advanced kidney disease. Kidney Int Rep 4(2):257–266CrossRefPubMed Lawitz Eric et al (2019) Efficacy and safety of ombitasvir/paritaprevir/ritonavir in patients with hepatitis C virus genotype 1 or 4 infection and advanced kidney disease. Kidney Int Rep 4(2):257–266CrossRefPubMed
16.
go back to reference Gane EJ, Sola R, Cohen E et al (2016) Efficacy and safety of a ribavirin-free ombitasvir/paritaprevir/ritonavir ± dasabuvir regimen in patients with severe renal impairment or end-stage renal disease and HCV genotypes 1a or 4 infection. Hepatology 63(S1):470A–471A Gane EJ, Sola R, Cohen E et al (2016) Efficacy and safety of a ribavirin-free ombitasvir/paritaprevir/ritonavir ± dasabuvir regimen in patients with severe renal impairment or end-stage renal disease and HCV genotypes 1a or 4 infection. Hepatology 63(S1):470A–471A
Metadata
Title
Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality
Authors
Ahmed Yahia Elmowafy
Hanzada Mohamed El Maghrabi
Khaled Farouk Eldahshan
Ayman Fathi Refaie
Mohammed Adel Elbasiony
Yasser Elsayed Matter
Hazem Hamed Saleh
Gamal Elsayed Shiha
Lionel Rostaing
Mohamed Adel Bakr
Publication date
01-09-2019
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 9/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02246-7

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