Coronavirus Live Count Map India
remove_red_eye 1367 Views
COVID-19 Vaccine Updates
#Gastroenterology #Nephrology #Transplantation
- Hepatitis C in dialysis patients is most common hepatotropic viral infection in HD patients.
- Prevalence of 12-45% in our HD units.
- Long term implications on dialysis and transplant outcome.
- Revolutionary change in management with availability of DAAs.
- Current WHO guidelines for non-CKD recommend: Sofosbuvir/velpatasvir, glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir.
- KDIGO does not recommend sofasbuvir: This drug has a predominantly renal excretion; Serum level of sofosbuvir and one of its downstream metabolites, GS-331007, are increased by nearly four-fold in CKD patients.
- Recommendations: Genotype 1 and 3: Sofosbuvir 400 mg + Daclatasvir 60 mg [total therapy cost INR 15k]; Pan genotype: sofosbuvir 400 mg + Velpatasvir 100 mg [total therapy cost INR 40K]; We now do transplants while on therapy and continue post-RT.