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Direct acting antiviral HCV treatment does not influence renal function

Matt Driedger1, Chrissi Galanakis2, Curtis Cooper1

  • 1Department of Medicine, University of Ottawa.

Medicine
|June 3, 2020
PubMed

Insights

Hepatitis C virus (HCV) direct-acting antiviral (DAA) treatments generally maintain kidney function. Most HCV patients show stable glomerular filtration rate (GFR) after DAA therapy, with no significant impact on treatment efficacy.

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.

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