Abstract: Objective The aim of this study was to observe the virological response to half-dose of sofosbuvir and full-dose of daclatasvir therapy in patients with end-stage renal disease (ESRD) and acute hepatitis C (AHC). Methods 49 patients with ESRD and AHC who underwent long-term hemodialysis in our hospital were enrolled between June 2020 and January 2022, and were randomly divided into observation (n=25) and control (n=24) groups, receiving half-dose of sofosbuvir and full-dose of daclatasvir or full-dose of sofosbuvir and full-dose of daclatasvir antiviral therapy for 12 weeks. Serum HCV RNA load was detected by RT-PCR, and the peripheral blood T lymphocyte subsets were detected by flow cytometry. Results The rapid virological response, end-of-treatment virological response, 12-week sustained virological response (SVR12) and SVR24 in the observation group were 72.0%, 96.0%, 88.0% and 88.0%, not significantly different compared to 70.8%, 95.8%, 87.5% and 87.5% in the control group (P>0.05); at the end of antiviral treatment, the estimated glomerular filtration ratein the observation group was (12.5±1.0)ml/min·1.73m², much higher than , while serum creatinine level was (448.5±11.7)μmol/L, much lower than in the control; there were no significant differences as respect to the percentages of peripheral blood CD₄⁺cells and CD₈⁺cell as well as the CD₄⁺/CD₈⁺cell ratio between the two groups at the end of antiviral treatment or of the follow-up (P>0.05);the incidence of untoward effects in the observation group during the antiviral therapy was 4.0%, much lower than 25.0%(P<0.05)in the control group. Conclusion The modified half-dose of sofosbuvir and full-dose of daclatasvirin treating patients with ESRD and AHC is relatively efficacious, which might meet the request of antiviral therapy and the reduction of renal function injury, and needs multi-central verification.

Key words: Hepatitis C, End-stage renal disease, Sofosbuvir, Daclatasvir, Therapy