Sofosbuvir-Based HCV Treatment in Maintenance Hemodialysis Patients: A Single-Center Study

There is scant data on use of sofosbuvir containing direct-acting antiviral (DAA) regimens in maintenance hemodialysis (MHD) patients infected with hepatitis C virus (HCV). Recent data have focused on possible safe use of sofosbuvir in MHD patients. The aim of this study was to study the efficacy and safety of the sofosbuvir-based combination DAA in HCV-infected naive patients on MHD. Before starting treatment HCV viral load, genotype, liver function tests, and liver ultrasound were performed in all patients. HCV RNA quantification was assessed at baseline, at end of therapy, at 12 weeks, and 24 weeks after stopping therapy. Forty-three MHD patients (67.4% male, with no cirrhosis) with HCV infection were included in the study. Fifteen patients were diabetics. Thirteen patients received multiple transfusions. None of the patients had baseline cirrhosis. Average vintage of dialysis was 6.2 years. At 24-week follow-up none of the patients relapsed. Full dose sofosbuvir was used in combination with ledipasvir (N = 40, 100% genotype 1) and valpatasvir (N = 3, 2 genotype 1, 1 genotype 3). Sustained virological response (HCV RNA < 12 IU/mL) at 12 and 24 weeks after stopping treatment was seen in 100% of the patients. Full-dose sofosbuvir-based DAA therapy is highly effective for MHD patients with HCV infection.