Safety and efficacy of sofosbuvir‐based treatment of acute hepatitis C in end‐stage renal disease patients undergoing haemodialysis

Summary Background Hepatitis C virus ( HCV ) infection in patients undergoing haemodialysis is prevalent and aggressive. The treatment of chronic hepatitis C has been revolutionised by the advent of direct‐acting antivirals ( DAA s). However, the safety, efficacy, and tolerance of DAA s in the treatment of acute HCV infection in patients with end‐stage renal disease who are on haemodialysis are unknown. Aim To evaluate the safety and efficacy of sofosbuvir plus daclatasvir in this specific, difficult‐to‐treat population. Methods We conducted a prospective and observational study of end‐stage renal disease patients who were undergoing haemodialysis and were acutely infected with HCV . Patients received a half dose of sofosbuvir (200 mg) and a full dose of daclatasvir (60 mg) daily. The primary endpoint was the proportion of patients with sustained virological responses ( SVR s); the other primary outcomes were safety and tolerability. Results Thirty‐three patients were enrolled in the study. The median HCV RNA viral load at baseline was 6.8 log 10 IU / mL . Twenty‐four patients were infected with HCV genotype 2a, seven patients with 1b, and two patients with 2a+1b. All patients achieved a SVR at 12 weeks after the end of treatment. The treatment was well tolerated, and there were no drug‐related serious adverse events. Conclusion A half dose of sofosbuvir (200 mg once daily) plus a full dose of daclatasvir (60 mg once daily) were suitable for the treatment of acute HCV ‐infected patients who were undergoing end‐stage renal disease and were on haemodialysis.