Full-dose sofosbuvir plus low-dose ribavirin for hepatitis C virus genotype 2-infected patients on hemodialysis
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Background/Aims: New direct-acting antivirals have shown surprising success in the treatment of hepatitis C, not only in the general population, but also in difficult- to-treat cohorts. However, there is still limited data regarding direct-acting antivirals, including sofosbuvir (SOF), in the context of hemodialysis. The aim of this study was to investigate the safety and outcome of administering full-dose SOF (400 mg/day) plus low-dose ribavirin (RBV, 100 to 200 mg/day) in hemodialysis patients with hepatitis C virus (HCV) genotype 2 (GT2) infection. Methods: Patients with chronic HCV GT2 infection and end-stage renal disease on maintenance hemodialysis treated with full-dose SOF plus low-dose RBV were retrospectively identified from a database of patients with HCV GT2 who were treated in Konkuk University Chungju Hospital between February 2017 and February 2018. Medical records were reviewed for demographics, medical history, laboratory data, and radiologic and electrocardiographic findings. Results: All nine patients completed a full course of 12 weeks of treatment with a full-dose SOF plus low-dose RBV regimen. Two had compensated cirrhosis. Seven patients were treatment-naïve, and two had a relapse following previous interferon-based therapy. All patients had a sustained viral response at 12 weeks post-treatment. There was no discontinuation of treatment because of side effects. Conclusions: In hemodialysis patients with HCV GT2 infection, the full-dose SOF plus low-dose RBV regimen appears to be safe and well tolerated, and yields high rates of sustained virologic response.
Abstract
Background/Aims: New direct-acting antivirals have shown surprising success in the treatment of hepatitis C, not only in the general population, but also in difficult- to-treat cohorts. However, there is still limited data regarding direct-acting antivirals, including sofosbuvir (SOF), in the context of hemodialysis. The aim of this study was to investigate the safety and outcome of administering full-dose SOF (400 mg/day) plus low-dose ribavirin (RBV, 100 to 200 mg/day) in hemodialysis patients with hepatitis C virus (HCV) genotype 2 (GT2) infection. Methods: Patients with chronic HCV GT2 infection and end-stage renal disease on maintenance hemodialysis treated with full-dose SOF plus low-dose RBV were retrospectively identified from a database of patients with HCV GT2 who were treated in Konkuk University Chungju Hospital between February 2017 and February 2018. Medical records were reviewed for demographics, medical history, laboratory data, and radiologic and electrocardiographic findings. Results: All nine patients completed a full course of 12 weeks of treatment with a full-dose SOF plus low-dose RBV regimen. Two had compensated cirrhosis. Seven patients were treatment-naïve, and two had a relapse following previous interferon-based therapy. All patients had a sustained viral response at 12 weeks post-treatment. There was no discontinuation of treatment because of side effects. Conclusions: In hemodialysis patients with HCV GT2 infection, the full-dose SOF plus low-dose RBV regimen appears to be safe and well tolerated, and yields high rates of sustained virologic response.
참고문헌 (20)
- Polaris Observatory HCV Collaborators, "Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : a modelling study", Lancet Gastroenterol Hepatol, 2, pp.161~176 (2017)
- European Union HCV Collaborators, "Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030 : a modelling study", Lancet Gastroenterol Hepatol, 2, pp.325~336 (2017)
- Smolders EJ, "Pharmacokinetics, efficacy, and safety of hepatitis C virus drugs in patients with liver and", or renal impairment, 2016, pp.39, 589~611
- Fabrizi F, "Hepatitis C virus infection and dialysis : 2012update", ISRN Nephrol, 2013, pp.159760~ (2012)
- 진동찬, "Current characteristics of dialysis therapy in Korea: 2015 registry data focusing on elderly patients", Kidney Research and Clinical Practice, 35(4), pp.204~211 (2016), 대한신장학회
- Wahle RC, "Does hepatitis B virus coinfection have any impact on treatment outcome in hepatitis C patients on hemodialysis", Ann Hepatol, 14, pp.317~324 (2015)
- European Association for the Study of the Liver, "EASL recommendations on treatment of hepatitis C 2018", J Hepatol, 69, pp.461~511 (2018)
- Jong Eun Yeon, "Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: Comparison of guidelines from other continents, 2017 AASLD", IDSA and 2016 EASL, 2018, pp.24(3), 278~293[DOI]
- Lim SG, "Management of hepatitis C virus infection in the Asia-Pacific region : an update", Lancet Gastroenterol Hepatol, 2, pp.52~62 (2017)
- Carvalho-Filho RJ, "Management of hepatitis C in patients with chronic kidney disease", World J Gastroenterol, 21, pp.408~422 (2015)
- Mendizabal M, "Chronic hepatitis C and chronic kidney disease : advances, limitations and unchartered territories", J Viral Hepat, 24, pp.442~453 (2017)
- Mani N, "Nonstructural protein 5A(NS5A)and human replication protein A increase the processivity of hepatitis C virus NS5B polymerase activity in vitro", J Virol, 89, pp.165~180 (2015)
- Noell BC, "Changing the face of hepatitis C management : the design and development of sofosbuvir", Drug Des Devel Ther, 9, pp.2367~2374 (2015)
- "HCV guidance: recommendations for testing, managing, and treating hepatitis C" (2019)[URL]
- Desnoyer A, "Pharmacokinetics, safety and efficacy of a full dose sofosbuvir-based regimen given daily in hemodialysis patients with chronic hepatitis C", J Hepatol, 65, pp.40~47 (2016)
- Gane EJ, "Safety, antiviral efficacy, and pharmacokinetics of sofosbuvir in patients with severe renal impairment", 65th Annual Meeting of the American Association for the Study of Liver diseases (2014)
- He YL, "Safety and efficacy of sofosbuvir-based treatment of acute hepatitis C in end-stage renal disease patients undergoing haemodialysis", Aliment Pharmacol Ther, 47, pp.526~532 (2018)
- Saxena V, "Safety and efficacy of sofosbuvir-containing regimens in hepatitis C-infected patients with impaired renal function", Liver Int, 36, pp.807~816 (2016)
- Cox-North P, "Sofosbuvir-based regimens for the treatment of chronic hepatitis C in severe renal dysfunction", Hepatol Commun, 1, pp.248~255 (2017)
- Agarwal SK, "Hemodialysis patients treated for hepatitis C using a sofosbuvir-based regimen", Kidney Int Rep, 2, pp.831~835 (2017)