Skip to main content
SpringerLink
Log in

Renal profile of chronic hepatitis C patients with sofosbuvir-based therapy

  • Original Paper
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

The impact of SOF-based therapy on renal functions is quite controversial in clinical practice. Therefore, we aimed to evaluate the serial changes of renal indices during SOF-based therapy in CHC patients with normal kidney function or mild renal impairment.

Methods

We retrospectively reviewed all CHC patients who received different SOF-based regimens from January 2015 until December 2017, and presented with a baseline eGFR ≥ 30 ml/min/1.73m2. Patients who didn't achieve SVR, with missing creatinine or eGFR data, and patients with eGFR less than 30 ml/min/1.73m2 at baseline were excluded. eGFR was calculated for each time of evaluation using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.

Results

A total of 1004 patients were finally included. The mean serum creatinine and eGFR levels varied between 0.84 mg/dl and 106.53 ml/min/1.73m2 for baseline and 0.87 mg/dl and 104.24 ml/min/1.73m2 for SVR12, respectively. The maximum increase of creatinine was 3.69 mg/dl and the maximum decrease of eGFR level was 83.30 ml/min/1.73m2 during treatment. Moreover, 74.4% of treated patients stayed in the same eGFR category, 14.3% progressed to a higher eGFR category, and 11.3% had an improvement eGFR category at EOT and continued to SVR12. Age > 65 years, baseline eGFR, and ribavirin–containing regimens were independent risk factors of eGFR decline during and after SOF-based treatment.

Conclusion

SOF-based therapies seem to be safe in CHC patients with baseline normal or slightly impaired renal function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. World Health Organization. Global Hepatitis Report 2017. Geneva: 2017.

  2. Fabrizi F, Plaisier E, Saadoun D, Martin P, et al. Hepatitis C virus infection, mixed cryoglobulinemia, and kidney disease. Am J Kidney Dis. 2013;61(4):623–37.

    Article  Google Scholar 

  3. Daniel KE, Saeian K, Rizvi S, et al. Real-world experiences with direct-acting antiviral agents for chronic hepatitis C treatment. J Viral Hepat. 2020;27(2):195–204.

    Article  CAS  Google Scholar 

  4. Welzel TM, Petersen J, Herzer K, Ferenci P, Gschwantler M, Wedemeyer H, et al. Daclatasvir plus sofosbuvir, with or without ribavirin, achieved high sustained virological response rates in patients with HCV infection and advanced liver disease in a real-world cohort. Gut. 2016;65:1861–70.

    Article  CAS  Google Scholar 

  5. Gane EJ, Robson RA, Bonacini M, et al. Safety, antiviral efficacy and pharmacokinetics of sofosbuvir in patients with severe renal impairment. Hepatology. 2014;60(Suppl. 1):667A.

    Google Scholar 

  6. D'Ambrosio R, Pasulo L, Giorgini A, Spinetti A, et al. Renal safety in 3264 HCV patients treated with DAA-based regimens: results from a large Italian real-life study. Dig Liver Dis. 2020;52(2):190–8.

    Article  CAS  Google Scholar 

  7. Liu CH, Lee MH, Lin JW, Liu CJ, et al. Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct acting antivirals. J Hepatol. 2020;72(5):839–46.

    Article  CAS  Google Scholar 

  8. Butt AA, Ren Y, Marks K, Shaikh OS, Sherman KE, ERCHIVES study. Do directly acting antiviral agents for HCV increase the risk of hepatic decompensation and decline in renal function? Results from ERCHIVES. Aliment Pharmacol Ther. 2017;45:150–9.

    Article  CAS  Google Scholar 

  9. American Diabetes Association. Standards of medical care in diabetes—2015. Diabetes Care. 2015;38(suppl 1):S1–S93.

    Google Scholar 

  10. Sterling RK, Lissen E, Clumeck N, et al. Development of a simple noninvasive index to predict significant fibrosis inpatients with HIV/HCV co-infection. Hepatology. 2006;43:1317–25.

    Article  CAS  Google Scholar 

  11. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.

    Article  Google Scholar 

  12. Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158(11):825–30.

    Article  Google Scholar 

  13. Abdel Alem S, Elsharkawy A, El Akel W, Abdelaziz AO, et al. Liver stiffness measurements and FIB-4 are predictors of response to sofosbuvir-based treatment regimens in 7256 chronic HCV patients. Expert Rev Gastroenterol Hepatol. 2019;13(10):1009–166.

    Article  CAS  Google Scholar 

  14. The Polaris Observatory. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2:161–76.

    Article  Google Scholar 

  15. Messina JP, Humphreys I, Flaxman A, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology. 2015;61:77–87.

    Article  Google Scholar 

  16. Pybus OG, Drummond AJ, Nakano T, et al. The epidemiology and iatrogenic transmission of hepatitis C virus in Egypt: a Bayesian coalescent approach. Mol Biol Evol. 2003;20:381–7.

    Article  CAS  Google Scholar 

  17. Taneja S, Duseja A, De A, Mehta M, et al. Low-dose sofosbuvir is safe and effective in treating chronic hepatitis C in patients with severe renal impairment or end-stage renal disease. Dig Dis Sci. 2018;63:1334–400.

    Article  CAS  Google Scholar 

  18. Fabrizi F, Martin P, Messa P, et al. New treatment for hepatitis C in chronic kidney disease, dialysis, and transplant. Kidney Int. 2016;89:988–94.

    Article  CAS  Google Scholar 

  19. Eletreby R, El-Serafy M, Anees M, Kasem G, et al. Sofosbuvir-containing regimens are safe and effective in the treatment of HCV patients with moderate to severe renal impairment. Liver Int. 2020;40(4):797–805.

    Article  CAS  Google Scholar 

  20. Alvarez-Ossorio MJ, Sarmento E, Castro R, et al. Impact of interferon-free regimens on the glomerular filtration rate during treatment of chronic hepatitis C in a real-life cohort. J Viral Hepat. 2018;25(6):699–706.

    Article  CAS  Google Scholar 

  21. Brennan BJ, Wang K, Blotner S, et al. Safety, tolerability, and pharmacokinetics of ribavirin in hepatitis C virus-infected patients with various degrees of renal impairment. Antimicrob Agents Chemother. 2013;57:6097–105.

    Article  CAS  Google Scholar 

  22. Bucsics T, Krones E. Renal dysfunction in cirrhosis: acute kidney injury and the hepatorenal syndrome. Gastroenterol Rep (Oxf). 2017;5:127–37.

    Article  Google Scholar 

  23. Gerbes AL. Liver cirrhosis and kidney. Dig Dis. 2016;34:387–90.

    Article  Google Scholar 

  24. Ferri C, Giuggioli D, Colaci M. Renal manifestations of hepatitis C virus. Clin Liver Dis. 2017;21:487–97.

    Article  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt

    Mohammad El-Sayed, Zeinab Abdellatif, Aisha Elsharkawy, Reham Abd Elmoniem, Rabab Fouad, Gamal Esmat & Shereen Abdel Alem

  2. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt

    Mohamed El Kassas

  3. Endemic Medicine Department, Abbassia Fever Hospital, Ministry of Health and Population, Cairo, Egypt

    Amaal Marzouk

  4. Department of Research Development, Badr University, Cairo, Egypt

    Gamal Esmat

Authors
  1. Mohammad El-Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zeinab Abdellatif
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aisha Elsharkawy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohamed El Kassas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Reham Abd Elmoniem
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amaal Marzouk
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rabab Fouad
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gamal Esmat
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shereen Abdel Alem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shereen Abdel Alem.

Ethics declarations

Conflict of interest

Gamal Esmat: speaker, advisory board member and investigator for Gilead Science while all other authors: nothing to be declared.

Ethical standards

The study was approved by the Institutional Review Board (IRB) of the Faculty of Medicine, Cairo University (N-38-2016). All patients were enrolled after written informed consent was obtained. The study was conformed to the ethical guidelines of the 1975 Declaration of Helsinki and its later amendments with Good Clinical Practice (GCP) guidelines.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

El-Sayed, M., Abdellatif, Z., Elsharkawy, A. et al. Renal profile of chronic hepatitis C patients with sofosbuvir-based therapy. Infection 48, 913–922 (2020). https://doi.org/10.1007/s15010-020-01505-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-020-01505-5

Keywords

Search

Navigation