Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease

Blé, Michel; Aguilera, Victoria; Rubín, Ángel; García‐Eliz, María; Vinaixa, Carmen; Prieto, M.; Berenguer, Marina

doi:10.1002/lt.23756

Cited by 31 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study of HCV-infected liver transplant recipients, DAAs and SVR improved renal function in those with mild CKD. 21 A prior study including 57 patients with eGFR < 60 ml/min per 1.73 m 2 showed SVR was associated with improvement in eGFR in a multivariable model. 22 A recent prospective study of 94 patients with HCV treated with sofosbuvir showed an average improvement in eGFR of approximately 10 ml/min per 1.73 m 2 at 1 year; however, there were only 9 patients with CKD, defined as eGFR < 45 ml/min per 1.73 m 2 in this study.…”

Section: Discussionmentioning

confidence: 95%

Direct-acting antiviral therapy slows kidney function decline in patients with Hepatitis C virus infection and chronic kidney disease

Sise

Chute

Oppong

et al. 2020

Kidney International

View full text Add to dashboard Cite

Hepatitis C virus (HCV) infection is common and can accelerate chronic kidney disease (CKD) progression. Direct-acting antiviral (DAA) therapies against hepatitis C have consistently shown rates of sustained viral remission. However, the effect on kidney function is unknown. In a retrospective observational cohort study of HCV-infected patients receiving DAA therapies from 2013 to 2017, the slopes of estimated glomerular filtration rate (eGFR) decline were compared in the three years before DAA therapy to the slope after therapy. Pre-and post-treatment albuminuria values were also compared. In all, 1,178 patients were included; mean age of 56, 64% male, 71% white, 21% were diabetic, and 42% with cirrhosis. In patients with eGFR less than 60ml/min per 1.73m 2 , the annual decline in eGFR in the three years prior to treatment was −5.98 ml/min per year (95% confidence interval −7.30 to −4.67) and improved to −1.32 ml/min per year (95% confidence interval −4.50 to 1.88) after DAA therapy. In patients with eGFR greater than 60ml/min per 1.73m 2 the annual decline in eGFR in the three years prior to treatment was −1.43 ml/min per year (95% confidence interval −1.78 to −1.08) and after DAA therapy was −2.32 ml/min per year (95% confidence interval −3.36 to −1.03). Albuminuria improved significantly in patients without diabetes, but not in those with diabetes. Predictors of eGFR improvement included having CKD at baseline and being non-diabetic. Events of acute kidney injury were rare, occurring in 29 patients, and unrelated to antiviral therapy in 76% of cases. Thus, DAA therapy for HCVs infection may slow CKD progression.

show abstract

Section: Discussionmentioning

confidence: 95%

Direct-acting antiviral therapy slows kidney function decline in patients with Hepatitis C virus infection and chronic kidney disease

Sise

Chute

Oppong

et al. 2020

Kidney International

View full text Add to dashboard Cite

show abstract

“…(46,47) The improvements in renal function seen in this study folowing DAA therapy are likely to reflect resolution of immune complex disease and improvement in diabetic control. (38,48,49) Several measures were taken to minimize potential confounders of immunosuppression and ongoing metabolic treatment. All patients were on stable antirejection therapy and were steroid free for at least 3 months after liver transplant.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Eradication with New Interferon‐Free Treatment Improves Metabolic Profile in Hepatitis C Virus‐Related Liver Transplant Recipients

et al. 2018

View full text Add to dashboard Cite

Interferon (IFN)-free, direct-acting antiviral (DAA) therapy agents provide a safe and efficacious treatment for liver transplant recipients with recurrent hepatitis C virus (HCV) infection. The aim of this study is to evaluate the impact of HCV eradication on the metabolic factors in liver transplant recipients. We completed a retrospective single-center study on HCV-related liver transplant recipients treated with IFN-free DAAs including both treatment-naive and treatment-experienced patients. IFN-free DAAs impact on the metabolic profile were assessed at baseline and sustained virological response (SVR) between 24 and 48 weeks. In total, 91 liver transplant recipients with recurrent HCV infection received IFN-free DAA treatment, 62 patients had IFN-based treatment failure, and 29 were treatment-naïve, of whom 87 (96%) achieved SVR. Eradication of recurrent HCV infection was associated with reduction in the treatment of diabetes and hypertension by 38% and 22% from the baseline respectively. Hemoglobin A1c (HbA1c) levels declined from mean 35.5 ± 4.3 mmol/mol to 33.3 ±3.6 mmol/mol at 44 weeks posttreatment (P = 0.03). Total cholesterol levels increased from 3.8 ± 0.9 mmol/L to 4.9 ± 0.9 mmol/L at 41 weeks posttreatment (P < 0.0001), reflecting a significant increase in serum low-density lipoprotein (LDL) levels (2.0 ± 0.8 to 2.9 ± 0.8; P < 0.0001). Estimated glomerular filtration rate (eGFR) levels increased from 64.9 ± 20 mL/minute to 69.6 ± 20 mL/minute at 24 weeks posttreatment (P = 0.0004). Glucose, lipid profile, and eGFR changes were independent of weight changes and immunosuppression dosage and trough levels. In conclusion, eradication of recurrent HCV infection by DAA therapy has beneficial impacts on glucose metabolism and renal profile and reverses the hypolipidemic effect of HCV in liver transplant recipients. These extrahepatic effects of DAA therapy need to be validated by larger prospective studies.

show abstract

“…In fact, current guidelines recommend to refer to a nephrologist in case of eGFR decline by > 25% or to a level < 60 ml/min [ 42 ]. Moreover, we cannot exclude that this slight decline could be followed by a late improvement, as previously found in liver transplant recipients with mild chronic kidney disease that achieved SVR after interferon-based regimens [ 43 ].…”

Section: Discussionmentioning

confidence: 92%

Trend of estimated glomerular filtration rate during ombistasvir/paritaprevir/ritonavir plus dasabuvir ± ribavirin in HIV/HCV co-infected patients

et al. 2018

View full text Add to dashboard Cite

The renal function is a key-issue in HIV/HCV co-infected patients, nevertheless, it has not established so far whether HCV treatment with new direct acting agents could impact on estimated glomerular filtration rate (eGFR) variations. In the present work, we examined the real-life data on renal function that have been prospectively collected in the SIMIT compassionate-use program of ombitasvir/paritaprevir/ritonavir plus dasabuvir (OBV/PTV/r + DSV) in 144 HIV/HCV genotype 1 co-infected patients. The population was 74% male, 30.5% in CDC stage C, with median age of 52 years (48.0–56.5) and median liver stiffness of 7.8 kPa (6.7–9.2). Median baseline eGFR was 102.0 (90.8–108.1), changing to 99.8 (83.5–104.8) at the end of treatment (EoT), and 100.0 (87.3–105.6) 12 weeks after the EoT (FU12), p<0.0001. No patient had grade 3–4 increase of creatinine. At EoT 60/144 (41.7%) patients had ≥ 5% reduction in their eGFR, confirmed at FU12 in 39/60 (65.0%) cases. Longer duration of HCV infection (cut-off 12.9 years), lower HCV-RNA viral load (cut-off 1,970,160 IU/ml) and lower platelet count (cut-off 167,000 x106/L) were significantly associated with eGFR decline at logistic analysis (adjOR 2.9, 95%CI 1.0–8.8, p = 0.05; adjOR 3.5, 95%CI 1.2–10.4, p = 0.02; adjOR 2.8, 95%CI 1.1–6.8, p = 0.03, respectively). After repeating the analysis throughout a mixed model, a higher eGFR decline was highlighted in patients concomitantly treated with tenofovir (p = 0.0001), ribavirin (p = 0.0001), or integrase inhibitors (p <0.0001), with longer duration of HIV (p = 0.0002) and HCV infection (p = 0.035), lower baseline HCV RNA (p <0.0001), previous HCV treatment (p<0.0001), and older age (p<0.0001). In conclusion, our study confirms a good renal safety profile of OBV/PTV/r + DSV treatment in HIV/HCV patients, and the median decline of 2 ml/min in eGFR, albeit statistically significant, is of doubtful clinical significance. The role of aging, concomitant therapies and duration of HIV/HCV infection needs to be further investigated.

show abstract

Improved renal function in liver transplant recipients treated for hepatitis C virus with a sustained virological response and mild chronic kidney disease

Cited by 31 publications

References 25 publications

Direct-acting antiviral therapy slows kidney function decline in patients with Hepatitis C virus infection and chronic kidney disease

Direct-acting antiviral therapy slows kidney function decline in patients with Hepatitis C virus infection and chronic kidney disease

Hepatitis C Virus Eradication with New Interferon‐Free Treatment Improves Metabolic Profile in Hepatitis C Virus‐Related Liver Transplant Recipients

Trend of estimated glomerular filtration rate during ombistasvir/paritaprevir/ritonavir plus dasabuvir ± ribavirin in HIV/HCV co-infected patients

Contact Info

Product

Resources

About