Objective: Approximately 10-16% of patients with hepatitis C virus (HCV) infection develop kidney disease and the prevalence of HCV infection in patients with impaired renal function is higher than the general population. HCV-positive patients undergoing hemodialysis (HD) have a higher mortality rate compared to HCV-negative patients, not only because of liver-related complications, but also because this contributes to atherogenesis and chronic inflammation. The purpose of antiviral treatment in chronic HCV infection is to eliminate HCV RNA, to obtain a sustained virologic response (SVR), i.e. negative HCV RNA at the end of the 3-month treatment, and to prevent liver complications. Introduction of direct-acting antivirals (DAAs), for the treatment of HCV infection has provided over 90% SVR in the general population. In this study, we aimed to evaluate the demographic characteristics, laboratory values and treatment results of HCV-infected hemodialysis patients treated with DAA.

Methods: In this retrospective, single-center observational study, patients undergoing HD in Istanbul Training and Research Hospital Hemodialysis Unit were evaluated. Anti-HCV-positive patients with HCV RNA >15 IU/ml were divided into 2 groups as patients receiving and not receiving DAA treatment. Age, gender, duration of hemodialysis, laboratory values and treatment protocols were recorded.

Results: Of the 289 patients followed in the HD unit, 11.4% (33/289) were anti-HCV-positive and 63.6% (21/33) were male, with a mean age of 50.87±7.18 years and HD treatment was given for 84.58±43.44 months. Only 13 patients were using DAA among 18 patients with HCV RNA >15 IU/ml. Standard dose of paritaprevir/ritonavir-ombitasvir/dasabuvir (PrOD) therapy was applied as the DAA protocol and ribavirin was added to the treatment protocol in HCV genotype 1a. All patients were found to have SVR. The most common side effects were fatigue and loss of appetite, and none of the patients had any side effects requiring discontinuation of the drug. Four of the five patients who did not receive treatment were foreign nationals and their DAA treatments could not be provided by Social Security Institution.

Conclusions: In HD patients, detection of HCV infection after its screening, and started treatment protocols with low side effects and high SVR will provide source control of HCV infection and decrease mortality and morbidity related to this infection.

Klimik Dergisi 2020; 33(1): 39-43.

Cite this article as: Sarı ND, Köse Ş, İnci A. [Results of direct-acting antiviral therapy in chronic hepatitis C patients undergoing hemodialysis]. Klimik Derg. 2020; 33(1): 39-43. Turkish.