Abstract
This study aimed to explore changes in hepatic and renal function indices in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAAs). Forty-three CHC patients treated with sofosbuvir (SOF)-containing regimens were enrolled. At the end of treatment, the estimated glomerular filtration rate (eGFR) level was significantly decreased and the serum creatinine (Scr) and uric acid (UA) levels were significantly increased compared with baseline levels (eGFR: 86.7 ± 20.4 vs 80.5 ± 21.3, P01 = 0.005; Scr: 83.9 ± 19.1 vs 89.6 ± 21.1, P01 < 0.001; UA: 323.7± 86.2 vs 358.5 ± 93.2, P01 < 0.001); no significant improvements were observed at 24 w post-treatment (eGFR: 86.7 ± 20.4 vs 81.4 ± 18.6, P02 = 0.013; Scr: 83.6 ± 17.9 vs 87.9 ± 18.3, P02 = 0.014; UA: 320.8 ± 76.3 vs 349.3 ± 91.0, P02 = 0.004). When the patients were grouped by liver conditions, non-cirrhotic patients and cirrhotic patients had decreased eGFR levels and increased Scr levels at the end of treatment; at 24 w post-treatment, the eGFR and Scr levels were significantly improved in non-cirrhotic patients (88.4 ± 21.7 vs 83.8 ± 18.5, P02 = 0.142; 84.4 ± 20.4 vs 87.0 ± 16.9, P02 = 0.088), while no obvious improvements were observed in cirrhotic patients (84.3 ± 18.7 vs 78.1 ± 18.6, P02 = 0.002; 83.2 ± 17.7 vs 89.2 ± 20.6, P02 = 0.006). Clinical physicians should closely monitor renal function in patients treated with SOF-containing regimens, especially in cirrhotic patients.
Highlights
Hepatitis C virus (HCV) is an important pathogen affecting approximately 130‒150 million people worldwide [1, 2]
This study aimed to explore changes in hepatic and renal function indices in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAAs)
Considering the increasing occurrence of cases with hepatotoxicity, nephrotoxicity, and drug-drug interactions (DDIs), this study aimed to explore the changes of hepatic and renal function indices in Chronic hepatitis C (CHC) patients treated with DAAs
Summary
Hepatitis C virus (HCV) is an important pathogen affecting approximately 130‒150 million people worldwide [1, 2]. With the wide application of DAAs, challenging issues regarding the efficacy and safety of new DAAs regimens have arisen, e.g., resistance-associated variants, drug-drug interactions (DDIs), HBV (hepatitis B virus) reactivation, hepatotoxicity and nephrotoxicity [9,10,11,12,13,14,15,16,17,18,19,20]. In October 2016, the United States Food and Drug Administration issued a black box warning regarding the risk for HBV activation with 9 DAAs, citing 24 cases that included 3 reports of acute liver failure Some cases with hepatotoxicity and nephrotoxicity associated with DDIs were reported in CHC patients with concomitant diseases, HBV or HIV co-infections, and liver transplantations [11, 14, 16, 17]
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