Effect of Sofosbuvir-Based Hepatitis C Virus Therapy on Kidney Function in Patients with CKD

Area of Science:

• Nephrology
• Hepatology
• Infectious Diseases

Background:

• Hepatitis C virus (HCV) infection is prevalent in patients with chronic kidney disease (CKD), potentially accelerating progression to end-stage renal disease (ESRD).
• Sofosbuvir, a direct-acting antiviral (DAA), is effective against HCV but its safety in CKD patients requires evaluation.

Purpose of the Study:

• To assess the safety and efficacy of sofosbuvir-based DAA therapy in patients diagnosed with CKD.
• To determine the rates of sustained virologic response (SVR) and adverse events in this population.

Main Methods:

• Retrospective observational cohort study of 98 patients with CKD (eGFR <60 ml/min/1.73 m² or indicators of kidney damage).
• Patients received sofosbuvir-based therapy; regression models analyzed SVR, adverse events, and changes in estimated glomerular filtration rate (eGFR).

Main Results:

• Overall SVR was 81%.
• Mean eGFR remained stable, with 7/98 patients experiencing a transient rise in creatinine.
• In stage 3 CKD patients, HCV cure correlated with a significant eGFR improvement (9.3 ml/min/1.73 m²).
• Adverse events occurred in 81% of patients, but serious events (17%) and discontinuations (8%) were infrequent.

Conclusions:

• Sofosbuvir-based DAA therapy demonstrates favorable safety and efficacy in patients with CKD and HCV infection.
• Treatment is associated with high SVR rates and a potential for renal function improvement in some patients.