How I Treat Hepatitis C Patient Awaiting Renal Transplantation |
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eMediNexus Coverage from:  ISNCON 2019
How I Treat Hepatitis C Patient Awaiting Renal Transplantation

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  • 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.
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