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Safety and efficacy of dual direct-acting antiviral therapy (daclatasvir and asunaprevir) for chronic hepatitis C virus genotype 1 infection in patients on hemodialysis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

An Erratum to this article was published on 07 March 2016

Abstract

Background

Hepatitis C virus (HCV) infection is a major comorbidity in patients receiving hemodialysis. Interferon-based antiviral therapy to eradicate HCV is less effective in patients receiving hemodialysis than patients without renal dysfunction. Recently reported combination therapy with two oral direct-acting antiviral drugs, daclatasvir and asunaprevir, both of which are metabolized in the liver and excreted into the bile ducts, reportedly showed a high rate of HCV eradication. We evaluated the safety and efficacy of this therapy in patients receiving hemodialysis.

Methods

The safety and viral responses were compared among patients infected with HCV genotype 1, between 28 patients receiving hemodialysis, and propensity score-matched 56 patients without renal dysfunction.

Results

The reduction in serum HCV RNA levels 1 day after the start of therapy was significantly larger (p = 0.0329) and the disappearance of serum HCV RNA occurred significantly earlier (p = 0.0017) in patients receiving hemodialysis than those without renal dysfunction. The rates of sustained virologic response, i.e., the eradication of HCV, were comparable between two groups; the rate of SVR12 was 100 % in patients receiving hemodialysis and 94.6 % in patients without renal dysfunction. No adverse constitutional events were observed in either of the groups. The elevation of serum alanine aminotransferase levels, a known adverse effect of these drugs, was observed in comparable rate of patients between the two groups.

Conclusions

The therapy with daclatasvir and asunaprevir has high antiviral efficacy in patients receiving hemodialysis with a comparable safety profile to patients without renal dysfunction.

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Acknowledgments

The authors thank Dr. Shintaro Ogawa, Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Science, for his technical assistance.

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Authors and Affiliations

  1. Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan

    Hidenori Toyoda, Takashi Kumada & Toshifumi Tada

  2. Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan

    Koichi Takaguchi

  3. Department of Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan

    Toru Ishikawa

  4. Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan

    Kunihiko Tsuji

  5. Department of Gastroenterology, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan

    Mikio Zeniya

  6. Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

    Etsuko Iio

  7. Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

    Etsuko Iio & Yasuhito Tanaka

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  1. Hidenori Toyoda
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  2. Takashi Kumada
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Correspondence to Hidenori Toyoda.

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Toyoda, H., Kumada, T., Tada, T. et al. Safety and efficacy of dual direct-acting antiviral therapy (daclatasvir and asunaprevir) for chronic hepatitis C virus genotype 1 infection in patients on hemodialysis. J Gastroenterol 51, 741–747 (2016). https://doi.org/10.1007/s00535-016-1174-4

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  • DOI: https://doi.org/10.1007/s00535-016-1174-4

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