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• W4255156795 abstract "Hepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting antivirals (DAAs). The aim of this study is to retrospectively analyse the current prevalence of HCV infection and efficacy and safety results with different DAA regimens in the haemodialysis population of 2 hospital areas. This is a multicentre, retrospective and observational study in which HCV antibodies were analysed in 465 patients, with positive antibody findings in 54 of them (11.6%). Among these, 29 cases (53.7%) with genotypes 1 and 4 were treated with different DAA regimens, including combinations of paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir and ledipasvir, with/without ribavirin. Mean age was 53.3 ± 7.9 years, 72.4% of patients were male and the most important aetiology of chronic kidney disease involved glomerular abnormalities. In 100% of cases, a sustained viral response was achieved after 24 weeks, regardless of DAA regimen received. Adverse effects were not relevant and no case required stopping treatment. In 15 cases, ribavirin was combined with the DAA. In these cases, the most significant adverse effect was anaemic tendency, which was reflected in the increase of the dose of erythropoietin stimulating agents, although none required transfusions. In summary, we conclude that new DAAs for the treatment of HCV in haemodialysis patients are highly effective with minimal adverse effects; it is a very important advance in HCV management. These patients are therefore expected to have a much better prognosis than they have had until very recently. La infección por el virus de la hepatitis C (VHC) es muy prevalente entre los pacientes en hemodiálisis y condiciona un peor pronóstico respecto a los que no la padecen. El tratamiento con interferón y ribavirina es mal tolerado y existen pocos datos sobre la experiencia con los nuevos antivirales de acción directa (AAD). El objetivo de este trabajo es estudiar retrospectivamente la prevalencia actual de la infección por el VHC y los resultados de eficacia y seguridad con distintas pautas de AAD en la población en hemodiálisis de 2 áreas hospitalarias. Estudio multicéntrico, retrospectivo y observacional en el que se analizan los anticuerpos frente al VHC en 465 pacientes, entre los que 54 de ellos eran positivos (11,6%). Entre estos, 29 casos (53,7%) con genotipos 1 y 4 fueron tratados con distintas pautas de AAD, que incluían combinaciones de paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir y ledipasvir, con/sin ribavirina. La edad media era de 53,3 + 7,9 años, el 72,4% eran varones y la causa más importante de la enfermedad renal crónica eran las alteraciones glomerulares. En el 100% de los casos se obtuvo una respuesta viral sostenida a las 24 semanas independientemente de la pauta de AAD recibida. Los efectos secundarios fueron poco relevantes y ningún caso precisó suspender el tratamiento. En 15 de ellos, se asoció ribavirina a los AAD. En estos casos, el efecto adverso más destacable fue la tendencia a la anemización, reflejada en el incremento de la dosis de agentes estimulantes de la eritropoyesis, aunque ninguno precisó transfusiones. En resumen, concluimos que los nuevos AAD para el tratamiento del VHC en pacientes en hemodiálisis presentan una gran eficacia, con mínimos efectos secundarios, y constituyen un avance muy importante en su manejo, con lo que cabe esperar un pronóstico mucho mejor que el que presentaban hasta muy recientemente." @default.
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• W4255156795 date "2017-03-01" @default.
• W4255156795 modified "2023-10-01" @default.
• W4255156795 title "Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients" @default.
• W4255156795 doi "https://doi.org/10.1016/j.nefroe.2017.04.010" @default.
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