Abstract
Background Direct-acting antivirals (DAAs) made a drastic change in the management of HCV infection. Sofosbuvir is one of the highly potent DAAs, eliminated mainly through the kidney. But concerns about renal safety during treatment may limit its use. Neutrophil gelatinase-associated lipocalin (NGAL) has been proven as a predictor of renal tubular injury. Hence, the aim of this work was to assess serum neutrophil gelatinase-associated lipocalin (NGAL) in HCV-positive patients before and after treatment with the sofosbuvir-based antiviral regimen. Methods This prospective study included 87 Egyptian patients with chronic HCV infection treated with sofosbuvir plus daclatasvir with or without ribavirin for 12 weeks. Serum NGAL was measured before and at the end of treatment (EOT). Analysis of NGAL and estimated glomerular filtration rate (eGFR) evolution was done. Results Our results showed a statistically significant decrease in serum NGAL (P=0.02) with a nonsignificant reduction in eGFR (P=0.02) with a nonsignificant reduction in eGFR (P=0.02) with a nonsignificant reduction in eGFR (P=0.02) with a nonsignificant reduction in eGFR (P=0.02) with a nonsignificant reduction in eGFR (Conclusions Sofosbuvir appears to have no nephrotoxic effects and is safe to treat patients with chronic HCV infection.
Highlights
Chronic hepatitis C virus (HCV) infection affects over 170 million people globally, and it is considered a challenging public health problem in Egypt [1, 2]
Assay of serum neutrophil gelatinase-associated lipocalin (NGAL) was done by the Enzyme-Linked Immune Sorbent Assay (ELISA) method, using the kit supplied by Shanghai Sunred Biological Technology Co., Ltd
Neutrophil gelatinase-associated lipocalin (NGAL) was added to monoclonal antibody enzyme well which is precoated with human neutrophil gelatinase-associated lipocalin (NGAL) monoclonal antibody incubation; neutrophil gelatinase-associated lipocalin (NGAL) antibodies labeled with biotin and combined with streptavidin-HRP were added to each other to form immune complex; for removal of the uncombined enzyme, incubation and washing again were done. en, chromogen solutions A and B were added. e liquid color changes into blue, and the color becomes yellow at the effect of acid. e chroma of color was positively correlated to the concentration of the Human Substance
Summary
Chronic hepatitis C virus (HCV) infection affects over 170 million people globally, and it is considered a challenging public health problem in Egypt [1, 2]. The aim of this work was to assess serum neutrophil gelatinase-associated lipocalin (NGAL) in HCV-positive patients before and after treatment with the sofosbuvir-based antiviral regimen. Our results showed a statistically significant decrease in serum NGAL (P 0.02) with a nonsignificant reduction in eGFR (P 0.06). Changes in serum NGAL levels (baseline compared to EOT) in patients ranked by KDIGO-CKD classification showed a significant decrease in stages 1 and 2 (P 0.14 and 0.034, respectively) and a nonsignificant decrease in stage 3 (P 0.25). EGFR changes after treatment in patients ranked by the same classifications showed a nonsignificant reduction in all stages (P > 0.05). Sofosbuvir appears to have no nephrotoxic effects and is safe to treat patients with chronic HCV infection
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