The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021

Reduction of Liver Fibrosis After Treatment with Elbasvir/Grazoprevir in Patients with Hepatitis C Infection in Chronic Kidney Disease on Hemodialysis, a Quasi-Experimental Study

Bayu Laksono (Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung)
Nenny Agustanti (Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital Bandung)
Rudi Supriyadi (Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung)
Muhammad Begawan Bestari (Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital Bandung)
Siti Aminah Abdurachman (Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital Bandung)



Article Info

Publish Date
12 May 2021

Abstract

Background: Approximately 5-60% of hemodialysis patients have comorbid of hepatitis C virus (HCV) infection. The survival rate of hemodialysis patients HCV is lower than those without HCV due to the risk of liver fibrosis and cardiovascular disease. The combination of Elbasvir and Grazoprevir is the drug of choice for these patients with HCV genotype 1 and 4 which mainly inherited in populations in Indonesia. However, a high cost is required for this genome testing.  Eradication of HCV might reduce liver fibrosis. One of the methods to evaluate liver fibrosis is by using APRI score. The aim of this study is to assess liver fibrosis using APRI score after  Elbasvir/Grazoprevir therapy completion.Method: This was a quasi-experimental study without a control group which conducted during April-November 2019 in Dr. Hasan Sadikin Hospital, Bandung. Patients with reactive anti HCV, detected HCV RNA without genotype test, and sustained virological response (SVR) 12 achieved were included. APRI score and HCV RNA tests were performed before and after 12 weeks end of therapy (SVR12). The data were analyzed using paired T-test at a 95% confidence level.Results: Approximately 30% of hemodialysis patients had HCV infection. A total of 37 HCV patients in the hemodialysis unit were given Elbasvir/Grazoprevir for 12 weeks. The APRI score before and after 12 weeks after therapy were 0.336 and 0.270 (p = 0.002) respectively.Conclusion: The combination of Elbasvir/Grazoprevir might reduce the degree of liver fibrosis based on APRI score from 0.336 to 0.270  in HCV patients with chronic kidney disease on hemodialysis

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Journal Info

Abbrev

jghe

Publisher

Subject

Medicine & Pharmacology

Description

The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy is an academic journal which has been published since 2000 and owned by 3 Societies: The Indonesian Society of Gastroenterology; Indonesian Association for the Study of the Liver; The Indonesian Society for Digestive ...