Preliminary experience with sofosbuvir-based treatment regimens for patients dependent on hemodialysis
Hepatitis C virus (HCV) infection is highly prevalent in patients with end-stage renal disease (ESRD), particularly in hemodialysis-dependent patients (estimated seroprevalence 7.8% to 44%) [1, 2]. Moreover, renal impairment and HCV infection are linked in several important aspects. HCV-infected patients with renal impairment are at increased risk of progression to cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality [3, 4, 5]. HCV infection also increases the risk of all-cause mortality in patients requiring hemodialysis . Hence, effective antiviral treatment for HCV is of great importance in this cohort. The advent of direct-acting antivirals (DAAs) revolutionized treatment options for HCV-infected patients. In India, the only available DAAs were sofosbuvir (SOF), daclatasvir (DCV), and SOF-ledipasvir (LED) combination. Although SOF is not recommended in patients with severe renal impairment due to predominant renal excretion, increasing evidence of safety and...
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