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J Nephropathol. 2021;10(3): e29.
doi: 10.34172/jnp.2021.29

Scopus ID: 85108718636
  Abstract View: 1628
  PDF Download: 614

Original Article

Impact of direct acting antiviral agents on kidney function in hepatitis C virus infected patients with chronic kidney disease

Wedad Adel Mahmoud 1* ORCID logo, Iman Ibrahim Sarhan 1 ORCID logo, Osama Mahmoud Mohamed 1, Hayam Ahmed Hebah 1 ORCID logo, Ossama Ashraf Ahmed 2, Lina Essam Khedr 1

1 Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Internal Medicine and Gastroenterology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
*Corresponding Author: *Corresponding author: Wedad Adel Mahmoud, Email: wedadadelabdo@gmail.com, , Email: wedadadel@med.asu.edu.eg

Abstract

Introduction: Hepatitis C virus (HCV) infection is strongly associated with chronic kidney disease (CKD). It is an independent risk factor for developing CKD and significantly increases morbidity and mortality in CKD patients. Treatment with newer direct-acting antiviral (DAA) regimens in patients with CKD is showing conflicting results as regards safety and efficacy.

Objectives: To evaluate the safety and efficacy of DAAs and their impact on kidney function in CKD patients.

Patients and Methods: We conducted a prospective observational study on 100 CKD patients stages 3-4, receiving treatment for HCV at MASRI (Faculty of Medicine Ain Shams University Research Institute), with two different DAAs regimens (sofosbuvir/daclatasvir with or without ribavirin and ombitasvir/paritaprevir/ritonavir [OMV/PTV/RTV] with ribavirin), completed over six months follow up. Serum creatinine, estimated glomerular filtration rate (eGFR), and proteinuria were followed during and after treatment.

Results: Sustained virological response (SVR) was achieved in all patients. Improvement of eGFR (8-15 mL/min/1.73 m2) and proteinuria was found in both study groups. Acute kidney injury (AKI) was uncommon; it occurred in three (3%) patients, out of them, two patients showed complete recovery. Adverse events were common (43%), but serious adverse events were uncommon (2%).

Conclusion: DAA regimens were effective and well-tolerated for HCV infected patients with stage 3-4 CKD, where viral clearance caused improvement in eGFR and proteinuria.


Implication for health policy/practice/research/medical education:

HCV infection might be associated with CKD. Direct-acting antiviral therapy is effective in CKD patients. Serious adverse effects and treatment discontinuations are rare. Improvement of kidney function occurs with viral clearance.

Please cite this paper as: Adel Mahmoud W, Ibrahim Sarhan I, Mahmoud Mohamed O, Ahmed Hebah H, Ashraf Ahmed O, Essam Khedr L. Impact of direct acting antiviral agents on kidney function in hepatitis C virus infected patients with chronic kidney disease. J Nephropathol. 2021;10(3):e29. DOI: 10.34172/jnp.2021.29.

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Submitted: 15 Aug 2020
Accepted: 06 Oct 2020
ePublished: 28 Oct 2020
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