Vol.:(0123456789) 1 3 International Urology and Nephrology https://doi.org/10.1007/s11255-019-02246-7 NEPHROLOGY - ORIGINAL PAPER Treatment of hepatitis C infection among Egyptian hemodialysis patients: the dream becomes a reality Ahmed Yahia Elmowafy 1  · Hanzada Mohamed El Maghrabi 1,5  · Khaled Farouk Eldahshan 1  · Ayman Fathi Refaie 1  · Mohammed Adel Elbasiony 2,3  · Yasser Elsayed Matter 1  · Hazem Hamed Saleh 1  · Gamal Elsayed Shiha 3  · Lionel Rostaing 4  · Mohamed Adel Bakr 1 Received: 24 February 2019 / Accepted: 21 July 2019 © Springer Nature B.V. 2019 Abstract Background and aims New direct-acting antiviral drugs have become the corner-stone treatment for HCV infection: they show promising results with accepted side-effects and low dropout rates. One of the available regimens is paritaprevir/ombi- tasvir/ritonavir (PTV/OMV/RTV). Our aim was to study the efficacy and safety of this drug regimen among HCV-positive hemodialysis patients. Methods This prospective single-center study was performed in the Urology and Nephrology Center, Mansoura University, Egypt. Ninety-six maintenance hemodialysis patients were screened for HCV antibodies. Positive results were found in 46 patients (47.9%). HCV PCR was assessed in all HCV-antibody-positive patients; positive results were found positive for 38 (82%); all patients were HCV genotype 4. Four patients were excluded due to advanced liver cirrhosis, liver malignancy, or metastatic breast cancer. Thirty-four patients were prescribed PTV/OMV/RTV for 3 months to treat HCV. Results Mean age was 43.2 ± 11.9 years. Most patients were male (67.6%). There was a rapid response to treatment: HCV PCR became negative by 4 weeks after starting treatment. By 12 and 24 weeks post-DAA therapy, there was a sustained viral response (SVR 12, SVR 24) in 100% of patients with improved liver-enzyme levels. Conclusion The PTV/OMV/RTV regimen was safe and effectively treated Egyptian HCV-positive genotype-4 hemodialysis patients. Keywords Antiviral agents · Chronic hemodialysis · Chronic hepatitis C · Drug interaction · DAA therapy Introduction Egypt has the highest prevalence of HCV worldwide. In 2008, the Egyptian Demographic Health Survey (EDHS) estimated the prevalence of HCV antibodies and HCV RNA among those aged 15–59 years to be 14.7 and 9.8%, respec- tively, based on a large national study [1]. Among Egyp- tians infected with HCV, more than 90% are genotype 4; the remainder are genotype 1 [2]. Chronic kidney disease always impacts negatively on the treatment of chronic hepatitis because of poor drug toler- ance, a higher prevalence of side-effects, and the complexi- ties of adapting drug dosages [3]. Conventional alpha interferon (IFN) was one of the avail- able treatments for HCV among hemodialysis patients with a sustained virological response (SVR) of 20–71%. Treatment- related withdrawal rates were 0–53%. Many clinical trials were included in Fabrizi et al.; meta-analysis that studied Lionel Rostaing and Mohamed Adel Bakr have contributed equally to the manuscript. * Lionel Rostaing LRostaing@chu-grenoble.fr 1 Urology and Nephrology Center, Mansoura University, Mansoura, Egypt 2 Egyptian Liver Research Institute and Hospital, Mansoura, Egypt 3 Internal Medicine Department, Mansoura University, Mansoura, Egypt 4 Service de Néphrologie, Dialyse, Aphérèses et Transplantation Rénale, CHU Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 09, France 5 Nephrology Department, Port-Said University, Port Fuad, Egypt