Effectiveness of Sofosbuvir regime in Hepatitis C virus infection in hemodialysis Pakistani patients: Single Centre Study

Background: Chronic Hepatitis C (CHC) infection is the most common chronic liver disease in patients with end-stage renal disease (ESRD) and highly prevalent on hemodialysis patients. The DOPPS data reported an overall prevalence of 13.5 percent among adult hemodialysis patients. The reported data in Pakistan reflected 26.02% hemodialysis patients with HCV infection. Over the last few years, the direct-acting antivirals have been revolutionary in the treatment of hepatitis C, and sofosbuvir (SOF) is the backbone of most modern treatment strategies with better prognosis of the infection and tolerability. The aim of the study was to assess the effectiveness and safety of Sofosbuvir regime on HCV infected patients on hemodialysis (HD) in the local population as per routine practice. Method: This was an observational, prospective; single-center study enrolled 30 HCV HD subjects on sofosbuvir ribavirin regime for 12 weeks. Results: As per results of 30 subjects' (n= female 13, 44% and n = male 17, 56 %) with mean age ± standard deviation 60.5 ± 7.5 years. On SOF/ribavirin (RBV) treatment for 12 weeks, the sustained virological response rate was 100% (27 of 27) at 12 weeks. 95% confidence interval, (95 to 100). No patients had virologic failure during treatment. No patient had treatment discontinuation due to side effects. Adverse events were reported in at least 10% of the patients were mainly pruritus, fatigue, and nausea. No serious adverse event reported. Conclusions: The Sofosbuvir based antiviral therapy is safe and effective in the treatment of HCV with ESRD, including HD patients with a high rate of SVR in patients.