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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Related Experiment Video

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Hemodialysis Patients Treated for Hepatitis C Using a Sofosbuvir-based Regimen.

Sanjay Kumar Agarwal1, Soumita Bagchi1, Raj Kumar Yadav1

  • 1Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.

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|December 23, 2017
PubMed
Summary

Sofosbuvir (SOF)-based direct-acting antiviral (DAA) therapy is effective and well-tolerated in patients undergoing maintenance hemodialysis (MHD). This study found a high sustained viral response (SVR) rate of 95.2% in MHD patients treated with SOF-based regimens.

Keywords:
DAAHCVIndiadaclatasvirhemodialysissofosbuvir

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Area of Science:

  • Hepatology
  • Virology
  • Nephrology

Background:

  • Limited data exists on sofosbuvir (SOF)-based therapy efficacy in patients on maintenance hemodialysis (MHD).
  • Hepatitis C virus (HCV) infection poses a significant challenge in MHD patients.
  • This study addresses the paucity of information on direct-acting antiviral (DAA) treatment in this specific population.

Purpose of the Study:

  • To evaluate the safety and efficacy of sofosbuvir (SOF)-based direct-acting antiviral (DAA) therapy in patients undergoing maintenance hemodialysis (MHD).
  • To describe the treatment experience and outcomes of MHD patients receiving SOF-based regimens in India.

Main Methods:

  • A cohort of 62 treatment-naïve patients on MHD receiving SOF-based therapy was studied.
  • Patients underwent baseline assessments including viral load, genotype, liver fibroscan, and endoscopy.
  • Treatment regimens included sofosbuvir (SOF) with ribavirin or daclatasvir for 12 weeks, with viral load monitoring.

Main Results:

  • A sustained viral response (SVR) of 95.2% was achieved across all genotypes.
  • The most common genotypes were genotype 1 (64.5%) and genotype 3 (29%).
  • While generally well-tolerated, 37% experienced complications such as dyspepsia, tuberculosis, and pneumonia; no patients discontinued therapy.

Conclusions:

  • Sofosbuvir (SOF)-based direct-acting antiviral (DAA) therapies are safe and effective for treating Hepatitis C virus (HCV) in patients on maintenance hemodialysis (MHD).
  • High SVR rates indicate the potential for widespread use of these regimens in MHD populations.
  • Further research may explore optimizing DAA regimens to minimize side effects in this vulnerable group.