Abstract: Objective The aim of this study was to investigate efficacy and safety of sofosbuvir and dacatavir combination in the treatment of patients with end-stage renal disease (ESRD) and concomitant chronic hepatitis C (CHC). Methods 42 CHC patients with ESRD were encountered in our hospital between May 2020 and May 2022, and all underwent maintenance hemodialysis. DAAs regimen was carried out by sorfosbuvir and dacatavir combination for all patients for 12 weeks and followed-up for 12 months. HCV genotypes was conducted by Simmonds gene typing. Rapid virological response (RVR), end of treatment virological response (ETVR), sustained virologic response six month (SVR6) and SVR12 were recorded. Results Genotypes infected in our series were 1b in 22 cases, 2a in 9 cases, 2b in 6 cases and 3 in 5 cases; except for SVR6 and SVR12 were 80.0% in patients with genotype 3 infection, the RVR, ETVR and SVR6 and SVR12 were all 100.0%(P>0.05) in patients with other three HCV genotype infection; by end of 12 month follow-up, serum ALT level in 42 patients with CHC was 23(20, 38)U/L, AST was 21(17, 35)U/L, both significantly lower than [61(42, 92)U/L and 59(45, 83)U/L, respectively, P<0.05] at baseline, while peripheral blood platelet count was 155(130, 194)×10⁹/L, and estimated glomerular filtration rate (eGFR) was 14.9(12.5,17.3)ml/min×1.73 m², both significantly higher than [122(98, 141)×10⁹/L and 9.3(8.0, 11.5)ml/min×1.73m², respectively, P<0.05] at baseline; there were no significant differences as respect to serum creatinine and urea levels before and after antiviral treatment (P>0.05); during direct antiviral agent (DAA) therapy, incidence of eight adverse events, including nausea, fatigue, itching, anorexia, hyperkalemia, hypoglycemia, hypertension and joint pain occurred in 55 episodes. Conclusion Application of DAA in dealing with patients with ESRD and complicated CHC have a satisfactory efficacy and safety, which warrants further clinical investigation.

Key words: Hepatitis B, End-stage renal disease, Sofosbuvir, Dacatavir, Therapy, Safety