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Impact of hepatitis C virus and direct acting antivirals on kidney recipients: a retrospective study

Mohamed Gendia1,2, Pietro Lampertico3,4, Carlo Maria Alfieri1

  • 1Unit of Nephrology, Dialysis and Renal Transplant, Department of Medicine, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico di Milano, Milan, Italy.

Transplant International : Official Journal of the European Society for Organ Transplantation
|December 24, 2018
PubMed

Insights

Direct acting antivirals (DAAs) effectively treat Hepatitis C virus (HCV) in kidney transplant patients, improving outcomes and showing a high safety profile. Treatment led to sustained virological response without negatively impacting kidney graft function.

Area of Science:

  • Nephrology
  • Hepatology
  • Transplantation Immunology

Background:

  • Hepatitis C virus (HCV) infection poses significant risks for kidney transplant recipients, potentially leading to poorer patient and graft outcomes.
  • Understanding the impact of HCV and emerging treatments is crucial for managing this patient population.

Purpose of the Study:

  • To evaluate the impact of active Hepatitis C virus infection on kidney transplant recipients.
  • To assess the safety and efficacy of direct-acting antivirals (DAAs) in treating HCV in kidney transplant patients.

Main Methods:

  • Retrospective analysis of 616 kidney transplant recipients.
  • Categorization into three groups: DAAs treated (Group A), untreated HCV RNA positive (Group B), and HCV RNA negative (Group C).
  • Monitoring of viral load, liver enzymes, proteinuria, and patient/graft survival.

Main Results:

  • All DAAs-treated patients achieved HCV RNA negativity, with 92.3% attaining sustained virological response (SVR).
  • The untreated HCV RNA positive group experienced significantly higher rates of liver enzyme elevation and death.
  • DAA treatment showed a high safety profile, with no significant negative impact on allograft function, particularly in well-functioning grafts.

Conclusions:

  • Active HCV infection adversely affects kidney transplant recipients.
  • DAAs are safe and effective for treating HCV in kidney transplant patients, leading to high SVR rates and improved outcomes.
  • DAA therapy demonstrates a favorable safety profile post-kidney transplant, preserving allograft function.

Keywords:
direct acting antiviralsgraft outcomehepatitis-Ckidney transplantation

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