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

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.

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Authors and Affiliations

Authors

Contributions

AYE: wrote the article, HME and YEM: collected the data, AFR and KFE: analyzed the data, ME: followed the patients from hepatology point of view, and HS: was the responsible for laboratory investigations. GMS: afforded the DAAs in help with Egyptian medical insurance. The work was under supervision of MAB and LR: they reviewed and finalized the article.

Corresponding author

Correspondence to Lionel Rostaing.

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Conflict of interest

Not funded. Mansoura Urology and Nephrology Center supported full laboratory and radiology investigations for the patients. Egyptian Liver Research Institute and Hospital afforded the direct antiviral in collaboration with Egyptian Health Insurance System.

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Elmowafy, A.Y., El Maghrabi, H.M., Eldahshan, K.F. et al. Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality. Int Urol Nephrol 51, 1639–1647 (2019). https://doi.org/10.1007/s11255-019-02246-7

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  • DOI: https://doi.org/10.1007/s11255-019-02246-7

Keywords

  • Antiviral agents
  • Chronic hemodialysis
  • Chronic hepatitis C
  • Drug interaction
  • DAA therapy