title: Effectiveness of Paritaprevir/Ritonavir/Ombitasvir/Dasabuvir in Hemodialysis Patients With Hepatitis C Virus Infection and Advanced Liver Fibrosis: Case Reports.
abstract: Hepatitis C virus infection is common among patients on hemodialysis therapy and is an important cause of morbidity and mortality. We investigated the safety and effectiveness of a paritaprevir/ritonavir/ombitasvir/dasabuvir regimen in a group of 10 patients on hemodialysis therapy with genotype 1a, 1b, or 4 hepatitis C virus infection who had predictors of unfavorable response, such as compensated cirrhosis (7 patients) or advanced fibrosis and failure of previous therapy (3 patients). The treatment, with or without ribavirin, was administered daily for 12 or 24 weeks. Clinical and virologic assessment was performed every 4 weeks during the treatment and at posttreatment weeks 4 and 12. All patients achieved a sustained virologic response at posttreatment week 12. 80% of patients reported at least one adverse event: fatigue and anemia of mild intensity were the most common; a single episode of moderate liver decompensation was observed. The paritaprevir/ritonavir/ombitasvir/dasabuvir antiviral regimen is effective and well tolerated in genotype 1 or 4 hepatitis C virus-infected patients on hemodialysis therapy with compensated cirrhosis and/or failure of previous treatments.
authors.affiliation: Internal Medicine, Gastroenterology and Hepatology, Agostino Gemelli Hospital, Rome, Italy. Electronic address: francesca.ponziani@yahoo.it.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Ponziani
authors.affiliation: Internal Medicine, Gastroenterology and Hepatology, Agostino Gemelli Hospital, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Siciliano
authors.affiliation: Ward of Infectious Diseases Hepatology, IRCCS Lazzaro Spallanzani, Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Lionetti
authors.affiliation: Infectious Diseases, S. Andrea Hospital, Rome, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Pasquazzi
authors.affiliation: Infectious Diseases, S. Andrea Hospital, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Gianserra
authors.affiliation: Ward of Infectious Diseases Hepatology, IRCCS Lazzaro Spallanzani, Rome, Italy.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: D'Offizi
authors.affiliation: Internal Medicine, Gastroenterology and Hepatology, Agostino Gemelli Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Internal Medicine, Gastroenterology and Hepatology, Agostino Gemelli Hospital, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
mesh_terms: D015081:2-Naphthylamine; D000813:Anilides / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage; D002219:Carbamates / Q000008:administration & dosage; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D047029:Lactams, Macrocyclic; D008103:Liver Cirrhosis / Q000150:complications*; D047028:Macrocyclic Compounds / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011392:Proline / Q000031:analogs & derivatives; D006435:Renal Dialysis; D019438:Ritonavir / Q000008:administration & dosage; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000008:administration & dosage; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D014633:Valine
chemical_list: D000813:Anilides; D000998:Antiviral Agents; D002219:Carbamates; D003521:Cyclopropanes; D047029:Lactams, Macrocyclic; D047028:Macrocyclic Compounds; D013449:Sulfonamides; C586094:ombitasvir; D014498:Uracil; D011392:Proline; D015081:2-Naphthylamine; C588260:dasabuvir; D014633:Valine; D019438:Ritonavir; C585405:paritaprevir
keywords: HCV genotype; Hepatitis C virus (HCV); advanced liver fibrosis; adverse event; antiviral regimen; case reports; cirrhosis; dasabuvir; decreased kidney function; direct-acting antivirals; end-stage renal disease (ESRD); hemodialysis; ombitasvir; paritaprevir; ribavirin; ritonavir; sustained virological response