Ferrokinetic and Hematological Inflammatory Markers in Dialysis Patients with Hepatitis C Treated with Direct-Action Antivirals

Abstract

Introduction: Hepatitis C has high prevalence in hemodialysis patients and promotes chronic inflammation.

Objective: To determine whether inflammatory, ferrokinetic, and hematological parameters are modified in patients with hepatitis C on hemodialysis with direct-action antiviral therapy.

Methods: This was a descriptive, observational, prospective cohort study conducted with a pharmacological intervention with sofosbuvir and daclastavir in patients with hepatitis C on hemodialysis at the Institute of Nephrology, Havana, Cuba. Demographic, anthropometric, clinical, hematological, ferrokinetic, liver and systemic inflammation variables were collected pretreatment, at 12 and 24 weeks after the start of treatment. Data processing was carried out using Statistical Package Social Science 23.0. The median and interquartile range were calculated for quantitative variables. Friedman's nonparametric paired-samples test was used.

Results: Twenty-one treatment-responsive patients were included, with 52.3% aged 45–64 years and 33.3% on hemodialysis for over 10 years. Median alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels decreased from 23.5 U/L and 21.5 U/L at baseline to 6.0 U/L and 8.0 U/L, respectively, by the end of the study. Median hemoglobin remained stable at 104.5 g/L. Serum iron and C-reactive protein showed no significant changes, while median ferritin levels dropped from 306.98 µg/L to 119.18 µg/L (*p* = 0.01).

Conclusions: Serum aminotransferase and ferritin levels decreased with the treatment used, while C-reactive protein and hematologic parameters did not change.