ANTIVIRAL THERAPY FOR HEPATITIS IN DIALYSIS PATIENTS: ALMATY CASE SERIES
Background: Patients with end-stage renal disease (ESRD) undergoing hemodialysis represent a high-risk group for chronic viral hepatitis and its complications. The development of pangenotypic direct-acting antivirals (DAAs) has significantly improved the prognosis of hepatitis C virus (HCV) infection in this population. However, local data from Central Asia, particularly Kazakhstan, remain limited.
Aim: To evaluate the efficacy and safety of antiviral therapy in a subgroup of 12 patients with chronic hepatitis B and/or C receiving maintenance hemodialysis at the Hepato Center in Almaty.
Methods: From a larger cohort of 164 hemodialysis patients with confirmed viral hepatitis, 12 patients received antiviral treatment between 2021 and 2023. Treatment regimens included pangenotypic DAAs for HCV (Sofosbuvir/Velpatasvir) and nucleos(t)ide analogs for HBV (entecavir or tenofovir). Sustained virological response (SVR12 and SVR24), liver function parameters, fibrosis regression (assessed via FibroScan), and adverse events were recorded.
Results: Of the 12 patients, 9 were HCV-positive (genotypes 1, 1b, or 3), 2 had HBV, and 1 had mixed HBV+HCV infection. All HCV patients were treated with SOF/VEL for 8–12 weeks. SVR12 and SVR24 were achieved in 100% of HCV-treated patients. The two HBV patients showed complete viral suppression after 24 weeks of treatment. One mixed-infection patient achieved full suppression of both viruses. FibroScan results showed fibrosis improvement in 7 of 10 patients re-evaluated post-treatment. Liver enzymes normalized in 11 patients. No severe adverse events occurred; two patients reported mild pruritus, and no anemia-related complications were observed.
Conclusion: Antiviral therapy with pangenotypic DAAs and nucleos(t)ide analogs was highly effective and well tolerated in hemodialysis patients with chronic hepatitis B and C. These findings demonstrate the feasibility and clinical benefit of integrating antiviral treatment into routine nephrology care for dialysis-dependent patients in Kazakhstan.
Arina Yespotayeva – MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology; arinayespotayeva@gmail.com; https://orcid.org/0000-0003-2582-1211, +77014919116
Kairat Kabulbayev – Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology, kairatkabulbayev@yahoo.com; https://orcid.org/0000-0002-5977-1569; +77017252640
Almagul Kurmanova – Professor, Head of the Department of Obstetrics and Gynaecology, Al-Farabi Kazakh National University, Almaty, Kazakhstan; alm_kurmanova@mail.ru; https://orcid.org/0000-0002-1859-3903; +77017616106
Abduzhappar Gaipov –MD, Associate Professor, Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan; abduzhappargaipov@gmail.com; https://orcid.org/0000-0002-9844-8772; +77013790637
Alexander Nersesov – Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Gastroenterology, alexander.nersesov@gmail.com; https://orcid.org/0000-0002-8601-3966;+77782190642
Assiya Kanatbayeva – Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology, kanatbayeva@mail.ru; https://orcid.org/0000-0003-0357-2269; +77013755559
Aigul Raissova - MD, Associate Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Gastroenterology, ram-79@mail.ru; https://orcid.org/0000-0001-8799-3401; +77772175410
Venera Ayupova – MD, Hepatologist, Department of Gastroenterology, Multidisciplinary Hospital of Qonayev, Qonayev City, Almaty Region, Kazakhstan; venera25_84@mail.ru; https://orcid.org/0000-0001-9861-6273; +77017154220
Meruyert Suleimenova – MD, PhD, research assistant, Al-Farabi Kazakh National University, Almaty, Kazakhstan; meruyert.sd@gmail.com; https://orcid.org/0000-0002-4861-7953; +77018435857
Nagima Mustapayeva– Associate Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology, nagimam.m@gmail.com; https://orcid.org/0000-0001-5963-7645
Aisulu Gainutdin – MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Gastroenterology; aisulu_gainutdin@mail.ru; https://orcid.org/0000-0002-5629-3848; +77473387471
Nazym Dauletbayeva – MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology; nazymdauletbayeva@gmail.com; https://orcid.org/0009-0006-4455-3362; +77755505452
Zhadyra Abiyeva –MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology; Abiyeva.zh@kaznmu.kz; https://orcid.org/0009-0008-2842-6712; +777024141410
Aigul Kadyrova – MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology; md.aigulkadyrova@gmail.com; https://orcid.org/0009-0009-8722-7809; +77752446228
Sarsenbay Karmakbayev – MD, assistant professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology; sarsenbaykarmakbayev@yahoo.com; https://orcid.org/0009-0004-2402-0062; +77072330393
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Yespotayeva A., Kabulbayev K., Kurmanova A., Gaipov A., Nersesov A.V., Kanatbayeva A., Raissova A., Ayupova V., Suleimenova M., Mustapayeva N., Gainutdin A., Dauletbayeva N., Abiyeva Zh., Kadyrova A., Karmakbayev S., Antiviral Therapy for Hepatitis in Dialysis Patients: Almaty Case Series // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (2), pp. 250-256. doi 10.34689/SH.2025.27.2.027Похожие публикации:
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