Abstract: Objective The aim of this study was to observe the direct acting antivirals (DAAs) in treatment of patients with chronic end-stage renal disease ((ESRD)) and concomitant hepatitis C virus infection. Methods 26 patients with ESRD and concomitant chronic hepatitis C (CHC) were enrolled in our hospital between January 2015 and January 2021, including 20 naïve cases and 6 peg-interfoeron-α2a and ribavirin combination treated cases. The patients with CHC had 1b infection in 9 cases, 2a infection in 5 cases, 3b infection in 6 cases and 6a infection in 6 cases. All patients received sophorbuvir (200 mg.d^-1) and daclatavir (90 mg.d^-1) combination anti-viral treatment for 24 weeks. The rapid virological response (RVR), end of treatment virological response (ETVR), sustained virological response at six month discontinuation (SVR 6) and SVR at 12 month discontinuation (SVR12) were recorded. Results The RVR, ETVR, SVR6 and SVR12 in all patients with different HCV genotype infection were 100.0%, except for in patients with 3b infection, in which the SVR6 and SVR12 were 83.3%, as one patients had relapse after discontinuation of DAA treatment; at admission, serum HCV RNA loads in naïve patients was 4.4(0.8,7.4)×10⁶IU/ml, much higher than 4.0(0.6, 6.0)×10⁶IU/ml in re-treated patients (P<0.05); after DAAs antiviral treatment, the SVR in naïve patients was 95.0%, not significantly different compared to 100.0% in re-treated patients (P>0.05); at admission, serum ALT and AST levels in 26 CHC patients were 92(57, 109)U/L and 86(54, 97)U/L, both got back to normal [27(19, 31)U/L and 19(17, 28)U/L, P<0.05] after treatment, while serum Cr levels had no significant changes [286.2(176.0, 391.2)μmol/L vs. 282.4(177.8, 387.9)μmol/L, P>0.05] in our series; during the period of antiviral treatment, there were eight kinds(43 case times)of DAAs-related untoward effects, including nausea in 38.5%, fatigue in 38.5%, anorexia in 30.8%, hyperkalemia in 26.9%, arthralgia in 11.5%, hypoglycemia in 7.7%, hypertension in 7.7% and hematuresis in 3.8%. Conclusion The DAAs regimen by fosbuvir and daclatasvir combination is efficacious and safe in treatment of patients with ESRD and CHC, which warrants further clinical investigation.

Key words: Hepatitis C, Chronic end-stage renal disease, Direct acting antivirals, Sophorbuvir, Daclatasvir, Therapy