Grazoprevir-Elbasvir in Hemodialysis Patients with Chronic Hepatitis C Virus Infection and Factors Associated with Sustained Virological Response

Background : Patient on hemodialysis (HD) at risk of Hepatitis-C Virus (HCV) infection. HCV infection increase mortality related chronic liver and cardiovascular disease. Direct-Acting Antiviral (DAA) Drugs cure rate for HCV infection above 90%. Most DAA metabolite eliminated by kidney is not safe for hemodialysis patients. Grazoprevir+Elbasvir is the drug of choice for chronic-HCV infection in hemodialysis patients,and have higher cure rates and less adverse events. Until now the factors that influence therapeutic response of Grazoprevir+Elbasvir in HD patients is still unknown.

Objective: Assessing therapeutic response and side effect of Grazoprevir+Elbasvir for Hepatitis C Virus in routine hemodialysis patient.

Methods: Cohort prospective observational study on all patients with Chronic HCV infection with routine HD. Clinical and Laboratory Data was collected and analysed for therapeutic response and determined the factors that related with therapeutic response.Viral load, degree of fibrosis, and duration of HD treatment and relation with respons SVR12 as analysed using bivariate method of statistical analysis.

Results: 75 subjects that met inclusion criteria. The average age is 50.2±13.2years, subjects with more female were found. The duration of HD is 6.9±4.7years. Seventy of 72 (97.2%) patients achieved SVR12 (undetectable virus <10IU/mL). Relative risk of SVR12 based on viral load <800,000 IU/mL versus ≥800,000 IU/mL were 1.01 (95%CI 0.93-1.10;p=1.00),  F4 versus to F0-F3 were  0,95 (95%CI 0.81-1.10;p=0.35), duration of HD <3 years versus ≥3 years were 1.04 (95%CI 0.99-1.09;p=1.00).Three deaths while on Grazoprevir+Elbasvir, not related to this therapy. The side effect of this drug is minimal.