Journal of Gastroenterology

, Volume 51, Issue 7, pp 741–747 | Cite as

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

  • Hidenori ToyodaEmail author
  • Takashi Kumada
  • Toshifumi Tada
  • Koichi Takaguchi
  • Toru Ishikawa
  • Kunihiko Tsuji
  • Mikio Zeniya
  • Etsuko Iio
  • Yasuhito Tanaka
Original Article—Liver, Pancreas, and Biliary Tract



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.


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.


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.


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


Chronic hepatitis C Direct-acting antiviral drugs Hemodialysis Safety Viral response 



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

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Hidenori Toyoda
    • 1
    Email author
  • Takashi Kumada
    • 1
  • Toshifumi Tada
    • 1
  • Koichi Takaguchi
    • 2
  • Toru Ishikawa
    • 3
  • Kunihiko Tsuji
    • 4
  • Mikio Zeniya
    • 5
  • Etsuko Iio
    • 6
    • 7
  • Yasuhito Tanaka
    • 7
  1. 1.Department of GastroenterologyOgaki Municipal HospitalOgakiJapan
  2. 2.Department of HepatologyKagawa Prefectural Central HospitalTakamatsuJapan
  3. 3.Department of HepatologySaiseikai Niigata Daini HospitalNiigataJapan
  4. 4.Center for GastroenterologyTeine Keijinkai HospitalSapporoJapan
  5. 5.Department of Gastroenterology, Sanno HospitalInternational University of Health and WelfareTokyoJapan
  6. 6.Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical ScienceNagoyaJapan
  7. 7.Department of Virology and Liver UnitNagoya City University Graduate School of Medical ScienceNagoyaJapan

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