Abstract
Background and Objectives: Hepatitis C virus (HCV) infection is highly prevalent among patients undergoing chronic hemodialysis in emerging countries and is associated with significant morbidity and mortality in this population. The objective of this study was to eradicate chronic HCV infection in patients undergoing chronic hemodialysis in Mauritania using a combination of sofosbuvir, 400 mg, and daclatasvir, 60 mg (direct acting antiviral-DAA-therapy), for 3 months. This was a prospective, single-arm, multicenter, interventional study. Materials and Methods: A total of 553 patients undergoing hemodialysis were screened for HCV across all hemodialysis centers nationwide. Biological parameters were compared before and after DAA therapy. Results: The prevalence of HCV infection was 6.8% (n = 38); two patients had undetectable HCV RNA. Out of the 36 eligible patients, 33 received DAA treatment. The median age of the patients was 49 (25-78) years. The average duration on hemodialysis was 9.4 (4-17) years. The median viral load before treatment was 538277 (10-4258571) IU/L. The median alanine aminotransferase (ALT) level was 52.3 (14-278) IU/L. The median hemoglobin level was 10 (6-13) g/dL. HCV viral load was undetectable at week 12 (W12) and week 24 (W24). The sustained virologic response (SVR) rate was 100%. Adverse events included one case of acute pancreatitis, six cases of fatigue (17%), five cases of headache (15%), four cases of diarrhea (12%), three cases of nausea (9%), and four cases of insomnia (12%). Conclusions: The combination of sofosbuvir and daclatasvir is effective in patients with HCV undergoing chronic hemodialysis, achieving a 100% SVR rate.