Direct acting antiviral HCV treatment does not influence renal function

Area of Science:

• Nephrology
• Hepatology
• Virology

Background:

• Hepatitis C virus (HCV) infection is a known risk factor for chronic kidney disease (CKD).
• Interferon-based therapies improved renal function in HCV patients, but data on direct-acting antiviral (DAA) regimens are limited.
• Understanding DAA effects on kidney function is crucial for managing HCV-infected individuals.

Purpose of the Study:

• To evaluate serial changes in kidney function after HCV treatment with direct-acting antiviral (DAA) regimens.
• To identify distinct trajectories of glomerular filtration rate (GFR) post-DAA therapy.
• To determine predictors of GFR changes and treatment outcomes.

Main Methods:

• A cohort of HCV-infected participants receiving DAA treatment was followed.
• Glomerular filtration rate (GFR) was estimated using the CKD-EPI equation at multiple time points post-treatment.
• Group-based trajectory modeling and multinomial regression analyzed GFR changes and predictors.

Main Results:

• Six distinct GFR trajectories were identified; 73% of patients showed stable renal function.
• A minority (27%) experienced declining renal function, but this was not consistently linked to DAA treatment or sustained virologic response (SVR).
• Diabetes was associated with lower post-treatment GFR, but not with declining GFR over time. Cirrhosis and SVR did not predict GFR trajectory.

Conclusions:

• The majority of HCV patients exhibit stable renal function following DAA treatment.
• DAA therapy and sustained virologic response (SVR) do not appear to have a consistent detrimental or beneficial effect on GFR over a 2-year period.
• Renal function status does not impact the efficacy of DAA-based regimens for HCV.