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ANTIVIRAL THERAPY FOR HEPATITIS IN DIALYSIS PATIENTS: ALMATY CASE SERIES

Authors

DOI:

https://doi.org/10.34689/q1yx4w67

Keywords:

Hepatitis C, Hepatitis B, Hemodialysis, Direct-Acting Antivirals, Sofosbuvir/Daclatasvir, ESRD, Kazakhstan, SVR, Liver Fibrosis

Abstract

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 HCVtreated 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 reevaluated 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.

Author Biographies

  • 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

  • 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

  • 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 

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • Assiya Kanatbayeva

    Professor, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan, Department of Nephrology, kanatbayeva@mail.ru; ; +77013755559

  • 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

  • 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

  • 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

  • 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

  • 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

References

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.2025.27.2.027

Еспотаева А., Кабулбаев К., Курманова А., Гаипов А., Нерсеcов А.В., Канатбаева А., Раисова А., Аюпова В., Сулейменова М., Мустапаева Н., Гайнутдин А., Даулетбаева Н., Абиева Ж., Кадырова А., Кармакбаев С. Противовирусная терапия гепатита у пациентов на диализе: серия случаев из Алматы // Наука и Здравоохранение. 2025. Vol.27 (2), С.250-256. doi 10.34689/SH.2025.27.2.027

Еспотаева А., Кабулбаев К., Курманова А., Гаипов А., Нерсеcов А.В., Канатбаева А., Раисова А., Аюпова В., Сулейменова М., Мустапаева Н., Гайнутдин А., Даулетбаева Н., Абиева Ж., Кадырова А., Кармакбаев С. Алматыдан жағдайлар сериясы: диализдегі пациенттердегі гепатитке қарсы терапия // Ғылым және Денсаулық сақтау. 2025. Vol.27 (2), Б. 250-256. doi 10.34689/SH.2025.27.2.027

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Published

2025-11-05

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Vol. 27 No. 2 (2025): Issue 2

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How to Cite

ANTIVIRAL THERAPY FOR HEPATITIS IN DIALYSIS PATIENTS: ALMATY CASE SERIES. (2025). Рецензируемый медицинский научно-практический журнал «Наука и здравоохранение», 27(2), 250-256. https://doi.org/10.34689/q1yx4w67

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