Research Article of Open Journal of Gastroenterology and Hepatology
Effectiveness and safety of glecaprevir and pibrentasvir for hemodialysis patients with hepatitis C virus infection at a single center
Department of Hepatology, Masuko Memorial Hospital
Background/Aims: Glecaprevir/pibrentasvir (GLE/PIB) is a pan-genotypic regimen for the treatment of hepatitis B virus (HCV) infection. GLE and PIB are direct acting antiviral (DAA) agents that can be used for patients with chronic renal failure who are on hemodialysis (HD) and those with HCV genotype 2 infections. Here, we report the usefulness and safety of GLE/PIB in 13 hemodialysis (HD) patients with HCV infection.
Material and Methods: The subjects comprised patients with genotype 1 and 2 (six each) and one unknown genotype patient in whom GLE/PIB therapy was introduced by December 2018. The mean age was 69.2 (59-78) years (seven men and six women). The mean HCV RNA amount prior to treatment initiation was 4.81 (2.1-6.5). The administration periods were 8 and 12 weeks (n = 9 and 4, respectively).
Results: Twelve patients received all the doses orally while an increase in total bilirubin (T-BIL) caused administration to be discontinued in one patient. HCV RNA at week 4 after treatment initiation became undetectable in 11 (91.6%) of the 12 patients. All patients achieved rapid viral response (RVR). Concerning adverse effects, although itching occurred in three (25%) patients, the symptom improved following administration of oral medication and the treatment was able to be continued.
Conclusion: The results suggest that GLE/PIB can also be safely administered to HD patients. However, the usefulness and safety need to be further studied by examining more cases.
Keywords: hepatitis C, hemodialysis
How to cite this article:
Naoki Hotta.Effectiveness and safety of glecaprevir and pibrentasvir for hemodialysis patients with hepatitis C virus infection at a single center. Open Journal of Gastroenterology and Hepatology, 2019, 2:26. DOI: 10.28933/ojgh-2019-11-2605
1. Fabrizi F, Dixit V, Messa P, Martin P. Hepatitis C-related liver diseases in dialysis patients. Contrib Nephrol 2012; 176: 42-53.
2. Kikuchi K, Akiba T, Nitta K, et al. Multicenter study of pegylated interferon α-2a monotherapy for hepatitis C virus-infected patients on hemodialysis: REACH study. Ther Apher Dial 2014; 18: 603-11.
3. Toyoda H, Kumada T, Tada T, et al. Safety and efficacy of dual direct-acting antiviral therapy (daclatasvir and asunaprevir) for chronic hepatitis C virus genotype 1 infection in patients on hemodialysis. J Gastroenterol 2016; 51: 741-7.
4. Suda G, Kudo M, Nagasaka A, et al. Efficacy and safety of daclatasvir and asunaprevir combination therapy in chronic hemodialysis patients with chronic hepatitis C. J Gastroenterol 2016; 51: 733-40.
5. Atsukawa M, Tsubota A, et al. Efficacy and safety of ombitasvir/paritaprevir/ritonavir in dialysis patients with genotype 1b chronic hepatitis C. Hepatol Res 2017; 47: 1429-36.
6. Edward G, Eric L, David P, et al. Glecaprevir and pibrentasvir in patients with HCV and severe renal impairment. N Engl J Med 2017; 12: 1448-55.
7. Hotta N. Efficacy and safety of glecaprevir/pibrentavir in combination therapy in chronic hemodialysis patients with genotype 2 hepatitis C virus infection.Open J Gastroenterol 2019; 9: 1-6.
8. Atsukawa M, Tsubota A, Toyoda H, et al. The efficacy and safety of glecaprevir/pibrentavir in 141 patients with severe renal impairment: prospective, multicenter study. Aliment Pharmacol Ther 2019; 49: 1-12.
9. Toyoda H, Chyayama K, Suzuki F, et al. Efficacy and safety of glecaprevir/pibrentavir in Japanese patients with chronic genotype 2 hepatitis C virus infection. Hepatology 2018; 67: 505-513.
10. Ura K, Furusyo N, Ogawa E, et al. Serum WFA(+) -M2BP is a non-invasive liver fibrosis marker that can predict the efficacy of direct acting anti-viral-based triple therapy for chronic hepatitis C. Aliment Pharmacol Ther 2016; 43: 114-24.
11. Shah AG, Lydecker A, Murray K, et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2009; 7: 1104-12.
12. Naoki H. M2BPGi Effects of dialysis. Sysmex Data 2017.
13. Kamimura K, Yokoo T, Kamimura H, et al. Long-term efficacy and safety of nalfurafine hydrochloride on pruritus in chronic liver disease patients: Patient-reported outcome based analyses. PLoS One 2017; 12: 1-11.
14. Okuubo T, Atsukawa M, Tsubota A, et al. Epidemiological survey of patients with hemodialysis complicated by hepatitis C in Japan. Ther Apher Dial 2019; 23: 44-8.
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.