title: Efficacy and safety of sofosbuvir-based regimens in chronic hepatitis C patients on dialysis.
abstract: BACKGROUND
  Patients with end-stage renal disease (ESRD) have poor treatment tolerance and outcome to interferon-based regimens. Sofosbuvir-based regimens have improved treatment success in chronic hepatitis C. There is limited data in ESRD patients as sofosbuvir is excreted by the kidney. Several small studies have shown good results.
  
  
  METHODS
  Sixteen consecutive patients of ESRD (on dialysis) and chronic hepatitis C were treated with sofosbuvir-based regimens as they were prospective kidney transplantation recipients, at a tertiary care center in north India. Sofosbuvir was given 400 mg on alternate days. Data is shown as number, mean (SD), and median (range).
  
  
  RESULTS
  Sixteen patients (12 males) aged 45±12 years received sofosbuvir-based treatment. These patients were on hemodialysis from 10 (2-48) months. Eleven of these patients had genotype 1, four had genotype 3, and one had genotype 4 infection; baseline RNA was 7 (5-8) log. The following treatment regimens were used: sofosbuvir, ribavirin, and low dose peginterferon (n = 8; 6 genotype 1 and one each had genotype 3 and 4); sofosbuvir and daclatasvir (n = 7); sofosbuvir, ribavirin, and daclatasvir (n = 1). Ten patients achieved end of treatment response and 8 (80%) of these achieved sustained virological response at 12 weeks (SVR12); six are on treatment. Two patients with genotype one (including one with cirrhosis) had relapse. Seven patients needed blood transfusion; interferon was stopped in one due to thrombocytopenia. Fatigue was present in 4 patients.
  
  
  CONCLUSIONS
  Sofosbuvir-based regimens can be used in ESRD patients on dialysis with good efficacy.
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Bodh
authors.affiliation: Medanta Kidney Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Shyam Bihari
authors.initials: SB
authors.lastname: Bansal
authors.affiliation: Medanta Kidney Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Reetesh
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Medanta Kidney Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Jain
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, Haryana, 122 018, India. neerajsaraf@hotmail.com.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D000069474:Sofosbuvir / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000069474:Sofosbuvir
keywords: Chronic kidney disease; Daclatasvir; Dialysis; Sofosbuvir; Sustained viral response