ledipasvir and Renal-Insufficiency--Chronic

Topics: Benzimidazoles; Fluorenes; Genotype; Hepacivirus; Hepatitis C; Humans; Renal Insufficiency, Chronic; Ribavirin; Sofosbuvir

There is scant data on use of sofosbuvir containing directly acting antiviral (DAA) regimens in chronic kidney disease (CKD) patients. Recently generic versions of DAAs 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).. 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).. 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.. 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).

Topics: Adult; Aged; Aged, 80 and over; Antiviral Agents; Benzimidazoles; Carbamates; Drug Therapy, Combination; Drugs, Generic; Female; Fluorenes; Genotype; Glomerular Filtration Rate; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; India; Liver Cirrhosis; Male; Middle Aged; Pyrrolidines; Renal Dialysis; Renal Insufficiency, Chronic; Ribavirin; Sofosbuvir; Sustained Virologic Response; Treatment Outcome; Valine; Viral Load; Young Adult

Topics: 2-Naphthylamine; Anilides; Benzimidazoles; Carbamates; Cyclopropanes; Fluorenes; Humans; Lactams, Macrocyclic; Macrocyclic Compounds; Proline; Renal Insufficiency, Chronic; Ritonavir; Sofosbuvir; Sulfonamides; Treatment Outcome; Uracil; Valine