Generic sofosbuvir‐based direct‐acting antivirals in hepatitis C virus‐infected patients with chronic kidney disease

摘要

Abstract Background & Aims There is scant data on use of sofosbuvir containing directly acting antiviral ( DAA ) regimens in chronic kidney disease ( CKD ) patients. Recently generic versions of DAA s have become available in low‐income countries including India. The aim of this study was to study the efficacy and safety of generic sofosbuvir in combination with generic ribavirin, ledipasvir or daclatasvir in HCV ‐infected patients with CKD including patients with advanced CKD ( CKD stage 4 or 5 with an estimated glomerular filtration rate ( GFR ) 30 mL /min or those on dialysis). Methods Seventy‐one CKD patients (76% male, 84.5% on maintenance haemodialysis, 23.9% cirrhosis) with HCV infection were included in the study. Full‐dose sofosbuvir was used in combination with ribavirin (n?=?26, for 24 weeks, 69.2% genotype 1, 30.8% genotype 3), ledipasvir (n?=?26, for 12?weeks, all genotype 1) and daclatasvir (n?=?19, for 12?weeks, all genotype 3). Results Sustained virological response ( SVR ) ( HCV RNA 12 IU / mL ) at 12 weeks after stopping treatment was seen in 100% of the patients in all the 3 groups. At 24‐week follow‐up after end of therapy, 1 patient in sofosbuvir plus ledipasvir group relapsed. At 48‐week follow‐up after end of therapy, 1 more patient in sofosbuvir plus ribavirin group relapsed. Conclusion Full‐dose sofosbuvir‐based DAA therapy using generics is highly effective for individuals with HCV infection and CKD including advanced CKD ( CKD stage 4 or 5 with an e‐ GFR 30 mL /min or those on dialysis).