Comparison between Sofosbuvir free regimen and Sofosbuvir based regimens in the treatment of chronic HCV patients with chronic renal failure

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Abstract Background: HCV infection is a major burden in Egypt as it affects 15% of the population. The treatment depends upon direct acting antivirals(DAAs). It was implied earlier that Sofosbuvir(SOF) better be avoided for potential toxic effects in patients with moderate to severe renal impairment. This study aims to evaluate the efficacy and safety of SOF-based regimens against SOF-free in this special population of patients Methods: This is a retrospective study where data for all HCV patients with chronic kidney disease including those with end stage renal disease and on haemodialysis were reviewed and 6607 patients were enrolled according to the National Committee for Control of Viral Hepatitis (NCCVH) in Egypt; these patients received variety of DAAs regimens including SOF-based and SOF-free regimens, and were categorized into two groups based on renal profile.Results: Sustained virological response (SVR) rate in this study was of 98.3%; 98.7% for those who were on SOF-based regimen and 95.6% for those administered SOF-free regimen. Regarding patients who were on haemodialysis, SVR rate was 100% in patients who received SOF-based regimen opposite to SVR rate of 91.2% in those who received SOF-free regimen. Moreover, in patients with moderate renal affection ‘grade 3 CKD’ SVR rates were 98.7% with SOF-based regimens and 97.6% for SOF-free regimens. Conclusion: SOF-based regimens at full dose are considered more effective than SOF-free regimens in patients with moderate to severe renal impairment with good safety profile and better SVR rate.

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