Safety and efficacy of direct-acting antivirals for chronic hepatitis C in patients with chronic kidney disease

BMC Nephrol. 2020 Jan 16;21(1):21. doi: 10.1186/s12882-020-1687-1.

Abstract

Background: This is a real-world evidence study that aims to analyze the efficacy, tolerability and safety profile of paritaprevir/ombitasvir/ritonavir and dasabuvir, in patients with renal impairment.

Methods: We conducted an observational prospective study, on 232 patients with chronic kidney disease, undergoing treatment with paritaprevir/ombitasvir/ritonavir and dasabuvir, for chronic hepatitis C infection - genotype 1b. Renal and liver function were assessed at the beginning of therapy, monthly during treatment and three months after therapy completion.

Results: All patients achieved sustained virologic response. Common side effects were nausea, fatigue and headache. Close monitoring of tacrolimus blood levels and dose reduction was required in kidney transplant recipients.

Conclusions: HCV therapy in the setting of renal dysfunction has always been a challenging topic. Direct-acting antivirals have shown promising effects, demonstrating good tolerance and efficacy in patients with HCV infection and renal impairment. Sustained virologic response within our study population was 100%.

Keywords: Chronic kidney disease; Direct-acting antiviral therapy; Hepatitis C virus; Kidney transplantation.

Publication types

  • Observational Study

MeSH terms

  • 2-Naphthylamine
  • Anilides / administration & dosage
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Carbamates / administration & dosage
  • Cryoglobulinemia / complications
  • Cyclopropanes / administration & dosage
  • Drug Therapy, Combination
  • Female
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Lactams, Macrocyclic / administration & dosage
  • Lupus Erythematosus, Systemic / complications
  • Male
  • Middle Aged
  • Proline / administration & dosage
  • Proline / analogs & derivatives
  • Prospective Studies
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / therapy
  • Ritonavir / administration & dosage
  • Sulfonamides / administration & dosage
  • Sustained Virologic Response
  • Uracil / administration & dosage
  • Uracil / analogs & derivatives
  • Valine

Substances

  • Anilides
  • Antiviral Agents
  • Carbamates
  • Cyclopropanes
  • Lactams, Macrocyclic
  • Sulfonamides
  • ombitasvir
  • Uracil
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • Valine
  • Ritonavir
  • paritaprevir