Effect and Safety of Sofosbuvir and Daclatasvir in the Treatment of Hepatitis C Virus Infection Among Yemeni Patients Who Are Undergoing Hemodialysis

Abstract

Background: Hepatitis C virus (HCV) infection remains one of the most frequently acquired infections among patients undergoing hemodialysis and is associated with substantial morbidity and progressive liver disease. In Yemen, evidence regarding the efficacy and safety of direct-acting antivirals (DAAs) in this population remains limited. This study aims to evaluate the effectiveness and safety of a combination regimen of sofosbuvir and daclatasvir in treating HCV infection among Yemeni patients undergoing hemodialysis. Methods: This prospective study included 28 Yemeni patients with confirmed HCV infection who were receiving maintenance hemodialysis between January 2023 and December 2024. The study was conducted in the dialysis unit of Al-Gomhori Hospital in Taiz City, Yemen. All patients received sofosbuvir (400 mg) and daclatasvir (60 mg) three times weekly for 12 weeks. Virological response was assessed using HCV RNA PCR at baseline, at the end of treatment to determine early virological response (EVR), and 12 weeks after treatment completion to assess sustained virological response (SVR12). Results: The study population comprised 14 males (50%) and 14 females (50%), with a mean age of 44 ± 12 years. At baseline, most patients (75%) had a low viral load, while 21% had a high viral load and 4% had a moderate viral load. EVR was achieved in 25 patients (89.3%). One patient (3.6%) had persistent detectable HCV RNA, one patient (3.6%) discontinued treatment due to adverse effects, and one patient (3.6%) died during the study period. Among patients who completed therapy, SVR12 was achieved in all cases (100%). Conclusion: The combination of sofosbuvir and daclatasvir administered three times weekly appears to be an effective and well-tolerated treatment option for HCV infection in patients undergoing hemodialysis in resource-limited settings.