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Kidney Int Rep. 2018 Oct 9;4(2):257-266. doi: 10.1016/j.ekir.2018.10.003. eCollection 2019 Feb.

Efficacy and Safety of Ombitasvir/Paritaprevir/Ritonavir in Patients With Hepatitis C Virus Genotype 1 or 4 Infection and Advanced Kidney Disease.

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The Texas Liver Institute, University of Texas Health, San Antonio, Texas, USA.
Auckland City Hospital, Auckland, New Zealand.
AbbVie Inc., North Chicago, Illinois, USA.
Baylor College of Medicine, Houston, Texas, USA.
Institute of Liver Studies, Kings College Hospital NHS Foundation Trust, London, UK.
Southern California GI and Liver Centers and Southern California Research Center, Coronado, California, USA.
The Liver Institute at Methodist Dallas, Dallas, Texas, USA.
Scripps Clinic, La Jolla, California, USA.
Medical Associates Research Group, San Diego, California, USA.
Tampa General Medical Group, Tampa, Florida, USA.
University of Florida Health Science Center, Gainesville, Florida, USA.
University of Pennsylvania, Philadelphia, Pennsylvania, USA.



Hepatitis C virus (HCV) infection is common in patients with end-stage renal disease. We investigated the safety and efficacy of ombitasvir (OBV)/paritaprevir (PTV)/ritonavir (r) ± dasabuvir (DSV) ± ribavirin (RBV) in 2 phase 3, open-label, multicenter studies in patients with stage 4 or 5 chronic kidney disease (CKD).


RUBY-I, Cohort 2 enrolled treatment-naïve or -experienced patients with HCV genotype (GT) 1a or 1b infection, with or without cirrhosis. Patients received 12 weeks (24 weeks for GT1a patients with cirrhosis) of OBV/PTV/r + DSV; all GT1a patients received RBV. RUBY-II enrolled treatment-naïve patients with GT1a or GT4 infection without cirrhosis. All patients received 12 weeks of RBV-free treatment: OBV/PTV/r + DSV for GT1a-infected patients; OBV/PTV/r for GT4-infected patients. The primary endpoint was sustained virologic response at posttreatment week 12 (SVR12).


RUBY-I, Cohort 2 and RUBY-II enrolled 66 patients, including 50 (76%) on dialysis; 15 (23%) had compensated cirrhosis. Overall, the SVR12 rate was 95% (63/66); 1 patient had virologic failure. There were 3 discontinuations due to adverse events. Seventy-three percent (27/37) of patients receiving RBV had adverse events leading to RBV dose modification. The RBV-free RUBY-II study had no hemoglobin-associated adverse events.


Treatment with OBV/PTV/r ± DSV ± RBV was well tolerated and patients with HCV GT1 or 4 infection and stage 4 or 5 CKD had high SVR12 rates, including patients with compensated cirrhosis and/or prior treatment experience.


NS3/4A protease inhibitor; NS5A inhibitor; RUBY; chronic kidney disease; renal disease

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