Is the Treatment with Direct Acting Antiviral Agents (DAAs) Affecting Glomerular Filtration Rate (GFR)?

Sarhan, Iman Ibrahem; Elsharabasy, Reem Mohsen; Mohamed, Mohamed Hassan Abdel Gawad; Ahmed, Fatma Abdelrahman

doi:10.21608/ejhm.2022.236803

Is the Treatment with Direct Acting Antiviral Agents (DAAs) Affecting Glomerular Filtration Rate (GFR)?

Document Type : Original Article

Authors

10.21608/ejhm.2022.236803

Abstract

Background: The kidney is a major component of extrahepatic manifestations of hepatitis C virus (HCV) clinical syndrome and the risk of chronic kidney disease (CKD) is more than 20% higher in patients with HCV infection than in seronegative individuals. Introduction ofdirect acting antivirals (DAA) represented a transforming point in the treatment of HCV.
Patients and Method: Retrospective cohort study of 118 adult HCV infected patients with normal baseline kidney functions and eGFR >60 ml/min were included. Patients coinfected with HBV and those with impaired kidney functions at beginning of treatment were excluded. Patients were divided into 3 groups according to their DAA-combination treatment regimen. Patients’ eGFR were measured at baseline, at the end of treatment and one year later.
Results: Our results showed that patients who received sofosbuvir/daclatasvir/ribavirin, their pre-treatment eGFR mean±SD was (86.156±16.37). Post treatment eGFR showed an insignificant change after end of treatment (84.736± 17.41) and 1 year after treatment (82.06± 18.07). Those who received sofosbuvir/daclatasvir, their pretreatment eGFR mean ±SD was (94.606 ±19.32). Post treatment eGFR showed an insignificant change after end of treatment (89.396 ±18.39) and 1 year after treatment (89.176±20.27). As for patients who received sofosbuvir/simeprevir, their pretreatment eGFR mean ± SD was (92.716 ± 15.11). Post treatment eGFR showed an insignificant change after end of treatment (88.366 ±16.27) and 1 year after treatment (89.016± 15.72).
Conclusion: The new direct antiviral agents like sofosbuvir, daclatasvir and simeprevir are safe regarding glomerular filtration rate in patients with normal renal function. However, the treated patients need careful monitoring of kidney function tests during the period of treatment.

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