Changes in renal function indices in chronic hepatitis C patients treated with sofosbuvir/daclatasvir, with or without ribavirin

Abstract

Abstract Background Hepatitis C virus HCV infection is one of the main causes of chronic liver disease worldwide, Egypt has the highest national-level HCV prevalence in the world, Sofosbuvir/Daclatasvir (SOF/DAC) regimen widely used to treat HCV infection in Egypt. Aim of the Study to assess changes in renal indices during and after HCV treatment in chronic hepatitis C patients treated with sofosbuvir/daclatasvir, with or without ribavirin with normal baseline creatinine Methods This study was a real life data analysis which recruited a number of “509” patients who received (SOF/DAC) regimen for 12 weeks with or without ribavirin in New Cairo viral Hepatitis Treatment Center, one of the NCCVH specialized centers. According to Supreme Council and NCCVH Hepatitis C Updated Treatment Protocol included patients received either: Sofosbuvir (400mg) + Daclatasvir (60mg) for 12weeks orSofosbuvir (400mg) + Daclatasvir (60mg) + Ribavirin for 12weeks. All data for chronic HCV patients who treated with sofosbuvir /daclatasvir, with or without ribavirin with normal baseline creatinine and achieved SVR,were compared to assess changes in renal indices during and after HCV treatment Results At the end of treatment, the estimated glomerular filtration rate (eGFR) level was significantly decreased and the serum creatinine( Scr) levels were significantly increased compared with baseline levels (eGFR: 91.63 ± 26.41 vs 85.71 ± 24.86, P01 < 0.001; Scr: .87 ± .20 vs.92 ± .22, P01 < 0.001and no significant improvements were observed at 24 w post-treatment (eGFR: 89.65 ± 26.14vs 91.63 ± 26.41 ,P02 = 0.029; Scr: .89 ± .24. vs 87 ± .20, P02 = 0.020. Considering the difference in liver conditions, changes in renal function indices were compared between cirrhotic patients and non-cirrhotic patients. At the end of treatment, cirrhotic patients and non-cirrhotic patients had decreased eGFR levels and increased Scr levels at 24 w post-treatment, the eGFR and Scr levels were significantly improved in non-cirrhotic patients, while no obvious improvements were observed in cirrhotic patients. Conclusion Although DAAs are highly effective and well tolerated, at the end of treatment we found that: The eGFR level was significantly decreased and the Scr levels were significantly increased compared with baseline levels and no significant improvements were observed at 24 w post-treatment.Both Cirrhotic patients and non-cirrhotic patients had decreased eGFR levels and increased Scr levels at 24 w post-treatment but the eGFR and Scr levels were significantly improved in non-cirrhotic patients , while no obvious improvements were observed in cirrhotic patients.