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Q2. Correct Answer: D
Rationale
Elbasvir and grazoprevir are hepaticaly metabo¬lized and undergo minimal renal elimination making them safe for use in patients with end stage renal disease. The C-Surfer trial evaluated elbasvir and grazoprevir in genotype 1 patients with advanced renal disease inclusive of patients on hemodialysis. Cure rates in this trial were 94- 99 percent. Sofosbuvir containing regimen are not approved for patient with CKD stage 4-5 or those on hemodialysis, even when given in a dose reduced or post-dialysis fashion.
References
https://www.hcvguidelines.org/unique-popula¬tions/renal-impairment
Roth D, Nelson DR, Bruchfeld A, et al. Grazoprevir plus elbasvir in treatment-naive and treat¬ment experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386(10003):1537-45.
Q2. Correct Answer: D
Rationale
Elbasvir and grazoprevir are hepaticaly metabo¬lized and undergo minimal renal elimination making them safe for use in patients with end stage renal disease. The C-Surfer trial evaluated elbasvir and grazoprevir in genotype 1 patients with advanced renal disease inclusive of patients on hemodialysis. Cure rates in this trial were 94- 99 percent. Sofosbuvir containing regimen are not approved for patient with CKD stage 4-5 or those on hemodialysis, even when given in a dose reduced or post-dialysis fashion.
References
https://www.hcvguidelines.org/unique-popula¬tions/renal-impairment
Roth D, Nelson DR, Bruchfeld A, et al. Grazoprevir plus elbasvir in treatment-naive and treat¬ment experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386(10003):1537-45.
Q2. Correct Answer: D
Rationale
Elbasvir and grazoprevir are hepaticaly metabo¬lized and undergo minimal renal elimination making them safe for use in patients with end stage renal disease. The C-Surfer trial evaluated elbasvir and grazoprevir in genotype 1 patients with advanced renal disease inclusive of patients on hemodialysis. Cure rates in this trial were 94- 99 percent. Sofosbuvir containing regimen are not approved for patient with CKD stage 4-5 or those on hemodialysis, even when given in a dose reduced or post-dialysis fashion.
References
https://www.hcvguidelines.org/unique-popula¬tions/renal-impairment
Roth D, Nelson DR, Bruchfeld A, et al. Grazoprevir plus elbasvir in treatment-naive and treat¬ment experienced patients with hepatitis C virus genotype 1 infection and stage 4-5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet. 2015;386(10003):1537-45.
A 47-year-old man with stage 5 chronic kidney disease on hemodialysis is referred to your clinic. He has genotype 1a HCV and F2 fibrosis. He wants to discuss treatment options.