Background and Aims:Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) who are dialysisdependent form a unique group,in which safety,tolerability and efficacy of sofosbuvir (SOF)-based direct-a...Background and Aims:Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) who are dialysisdependent form a unique group,in which safety,tolerability and efficacy of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) need further evaluation.Methods:We performed a retrospective analysis of 14 patients with CHC and ESRD on dialysis who received 15 courses of SOF-based therapy.We evaluated dose escalation to standard-dose SOF in this proof-of-principle experience.Results:Sustained virological response (defined as undetectable viral load at 12 weeks,SVR-12) was achieved in 13 out of the 15 (86.7%) treatment courses.Seven (46.6%) patients received reduced half dose as conservative proof-of-principal to mitigate potential toxicity.In 13 out of 15 treatment courses,patients completed the designated treatment duration.One patient was treated twice and developed SVR-12 with the retreatment.One patient was lost to follow-up and counted as a non-responder.Premature discontinuations were not due to DAA-related adverse effects.There were no reports of severe adverse effects or drug interactions.Conclusion:We treated CHC patients with ESRD using dose escalation to standard-dose SOF in this proof-of-principle experience and achieved SVR rates comparable to general population.展开更多
文摘Background and Aims:Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) who are dialysisdependent form a unique group,in which safety,tolerability and efficacy of sofosbuvir (SOF)-based direct-acting antivirals (DAAs) need further evaluation.Methods:We performed a retrospective analysis of 14 patients with CHC and ESRD on dialysis who received 15 courses of SOF-based therapy.We evaluated dose escalation to standard-dose SOF in this proof-of-principle experience.Results:Sustained virological response (defined as undetectable viral load at 12 weeks,SVR-12) was achieved in 13 out of the 15 (86.7%) treatment courses.Seven (46.6%) patients received reduced half dose as conservative proof-of-principal to mitigate potential toxicity.In 13 out of 15 treatment courses,patients completed the designated treatment duration.One patient was treated twice and developed SVR-12 with the retreatment.One patient was lost to follow-up and counted as a non-responder.Premature discontinuations were not due to DAA-related adverse effects.There were no reports of severe adverse effects or drug interactions.Conclusion:We treated CHC patients with ESRD using dose escalation to standard-dose SOF in this proof-of-principle experience and achieved SVR rates comparable to general population.
