Effectiveness and safety of direct-acting antiviral in hemodialysis patients with chronic hepatitis C: A real clinical experience

Background and Aims: Several clinical studies using direct-acting antivirals (DAAs) in maintenance hemodialysis (MHD) patients with chronic hepatitis C virus (HCV) infection have reported excellent antiviral efficacy and tolerability. Our study aimed to assess both the effectiveness and safety of DAAs in MHD patients complicated with HCV in a “real-life” clinical setting. Materials and Methods: A multicenter retrospective analysis of five dialysis centers included 155 patients of age >18 years with chronic HCV on MHD treated with various DAAs regimens for 12-week duration. The primary endpoint was sustained viral response and the secondary was the frequency of adverse effects (AEs). Results: Among the studied cohort, 96 (61.9%) were males and the mean age was 48.2 ± 12.6 years. Sustained virological response (SVR) was achieved in 153/155 (98.7%) patients. Normalization of liver enzymes was observed in patients with SVR (P < 0.05). None of the patients demonstrated deterioration in renal function. The minor AEs were reported in 12 patients - 8.1%. There were no severe AEs, dropouts, or deaths. Conclusion: DAAs are well tolerated and effective in our MHD patients. Strategies to eradicate HCV from dialysis units should consider DAA as treatment along with the practice of standard precautions to prevent nosocomial HCV infection.