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Year : 2023  |  Volume : 2  |  Issue : 1  |  Page : 22-26

Clinical profile and response to treatment in chronic hepatitis C and renal disease: A prospective study from North India

1 Department of Medical Gastroenterology, Asian Institute of Gastroenterology Hospitals, Hyderabad, Telangana, India
2 Department of Gastroenterology, Health Services Kashmir, Kashmir, India
3 Department of Internal Medicine, GMC Srinagar, Srinagar, India
4 Department of Medical Gastroenterology, Sher I Kashmir Institute of Medical Sciences, Soura, Srinagar, India
5 Department of Internal Medicine, GMC Baramulla, Baramulla, Jammu and Kashmir, India

Correspondence Address:
Dr. Aadil Ashraf
Department of Medical Gastroenterology, Asian Institute of Gastroenterology Hospitals, Mind Space Road, Gachibowli, Hyderabad 500032, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JIMPH.JIMPH_3_23

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BACKGROUND AND AIMS: Successful treatment of hepatitis C virus (HCV) infection is associated with improved outcomes in different clinical domains. The treatment of HCV infection in high-risk groups like chronic kidney disease (CKD) is challenging. We conducted a study on the efficacy of the fixed-dose combination of sofosbuvir–velpatasvir in CKD patients. MATERIALS AND METHODS: The study was conducted in our hospital, Sher I Kashmir Institute of Medical Sciences Soura. Patients with HCV infection (detectable RNA levels) with an estimated glomerular filtration rate (eGFR) >15 mL/min were included in the study. All the patients were evaluated for liver disease. Patients with prior exposure to a direct-acting antiviral agent, portal vein thrombosis, or hepatocellular carcinoma were excluded from the study. All the patients received an open-label combination of sofosbuvir and velpatasvir (400/100 mg). The primary endpoint was to assess sustained virological response 12 (SVR12), and the secondary endpoint was to assess the side effect profile of the patients. RESULTS: A total of 33 patients were enrolled in the study, with 17 in Group A (GFR 15–30 mL/min/1.73 m2) and 16 in Group B (GFR >30 mL/min/1.73 m2). In total, 142 (87.6%) achieved viral clearance at 4 weeks of therapy. Sixteen out of 17 (94.1%) in Group A and 13 out of 16 (81.25%) in Group B achieved viral clearance at 4 weeks of therapy [early virological respsone (EVR)]. All patients in both groups achieved end-of-treatment response viral clearance, and the same number of patients maintained viral clearance 12 weeks after stopping the treatment (SVR12). In Group A, no significant improvement was seen in the mean level of any parameters pre and posttreatment. In Group B, there was an improvement in all the parameters except serum creatinine after the completion of treatment. However, the difference was significant between pre and posttreatment values of serum alanine transaminase (U/L) and liver stiffness measurement levels (P value of −0.04 and 0.01, respectively). CONCLUSION: We conclude that treatment with sofosbuvir–velpatasvir is a safe and effective treatment option in HCV infection in CKD.

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