Evaluation of Treatment of Chronic HCV Patients in Chronic Kidney Disease Versus End Stage Renal Disease Patients
Evaluation of Treatment of Chronic HCV Patients in Chronic Kidney Disease Versus End Stage Renal Disease Patients
1. To asses curability of( Ombitasvir ,Paritaprevir,Ritonavir) in chronic HCV infected
 patients in those with CKD versus ESRD in Assiut Hospital University .

 2. Also assess duration of sustained viral response,treatment, relapse or failure of
 therapy in CKD versus ESRD in Assiut Hospital.
Hepatitis C virus (HCV) is a leading cause of liver disease worldwide, as 130-170 million
 individuals are chronically infected and 350,000 patients die every year from HCV infection.
 The HCV prevalence varies widely among countries being highest in several African and Eastern
 Mediterranean countries. So public health authorities should recognise the importance of HCV
 and make resources available for the implementation of effective primary prevention,
 screening and management policies .

 The hepatitis C virus (HCV) genotype is an important predictor of disease progression and
 treatment response. Genotype 1b has a worldwide distribution and is often found to be the
 most common genotype. HCV-genotype 4 causes approximately 20% of the 180 million cases of
 chronic hepatitis C in the world, is predominant in the Middle East and Northern Africa, and
 has recently spread to Southern Europe. Genotype 4 accounts for more than 90% of the reported
 cases from Egypt, a country with a massive HCV-related disease burden.

 The prevalence of anti-hepatitis C virus Ab (anti-HCV) positivity among dialysis patients
 varies across countries, ranging from 3 to 75%; unfortunately, Egypt is considered one of the
 countries with the highest prevalence despite the existence of guidelines for a comprehensive
 infection control program.

 In Egypt In the 15-59-year age groups, the prevalence of HCV antibody was found to be 10.0%
 and that of HCV RNA to be 7.0%. Approximately, 3.7 million persons have chronic HCV infection
 in the age group 15-59 in 2015.

 In the treatment of chronic HCV in renal impairment For patients with mild to moderate renal
 impairment (CrCl 30 mL/min-80 mL/min), no dosage adjustment is required when using fixed-dose
 combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) .

 Abbvie's 2D regimen (paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir(25mg)) was recently
 approved with specific indication for genotype 4 treatment naïve and experienced patients
 without cirrhosis achieved an sustained viral response rate of 100% following 12 weeks of 2D
 regimen with RBV, 2D can be used without RBV but may have slightly lower SVR (91% vs 100%).
 Currently, there is no FDA indication for 2D regimen use in patients with cirrhosis.

 . Ombitasvir (25 mg once daily), Paritaprevir (150 mg once daily), Ritonavir (100 mg once
 daily)Ribavirin (RBV): weight-based and divided bid (1000 mg/day if < 75kg or 1200 mg/day if
 ≥ 75kg) .
Inclusion Criteria:

 1. The patients aged from18- 60 years.

 2. Chronic HCV infection with Plasma HCV RNA greater than 15,000 IU/mL

 3. Treatment naïve.

 4. compensated liver cirrhosis.

 5. Absence of coinfection with HBV or HIV.

 Exclusion Criteria:

 1. Patients with hepatitis B virus or HIV.

 2. prior antiviral therapy.

 3. Haemoglobin level less than 10mg/dl.

 4. Decompensated liver disease.